MEDICARE: DR. NORBERTO VAZQUEZ M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME68625	FL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110248533	OTHER	FL	MEDICARE RAILROAD

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1336114339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORBERTO VAZQUEZ M.D.

Provider Business Mailing Address
First Line	:	1552 PALM BEACH LAKES BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-2302
Country	:	US
Telephone Number	:	561-659-7411
Fax Number	:	561-659-7423

Provider Business Practice Location Address
First Line	:	1552 PALM BEACH LAKES BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-2302
Country	:	US
Telephone Number	:	561-659-7411
Fax Number	:	561-659-7423

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	09/10/2013

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1552 PALM BEACH LAKES BLVD
WEST PALM BEACH, FL
33401-2302