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NPI Code Detail

MEDICARE: DR. HUMBERTO VAZQUEZ D.M.D., M.S.

MEDICARE: DR. HUMBERTO VAZQUEZ D.M.D., M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry1166PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
141186OTHERPRTRIPLE S, INC.

General Provider Information

NPI Number : 1003885401
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HUMBERTO VAZQUEZ D.M.D., M.S.
Provider Business Mailing Address
First Line : PO BOX 406
Second Line :
City : GUANICA
State : PR
Zip : 00653-0406
Country : US
Telephone Number : 787-841-5515
Fax Number : 787-841-5515
Provider Business Practice Location Address
First Line : URB MARIANI 1577 -MUNOZ RIVERA AVE.
Second Line : SUITE 2
City : PONCE
State : PR
Zip : 00717-0211
Country : US
Telephone Number : 787-840-5515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 05/06/2013

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