MEDICARE: DR. LILLIAM VAZQUEZ MALDONADO M.D.

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
1	208000000X	Pediatrics Physician	ACN685	FL
2	208000000X	Pediatrics Physician	ME145284	FL

General Provider Information

NPI Number	:	1235198920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LILLIAM VAZQUEZ MALDONADO M.D.

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	305-500-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7444 PALM RIVER RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-4128
Country	:	US
Telephone Number	:	813-392-1894
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	03/25/2026

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