MEDICARE: ADRIANO VAZQUEZ DIAZ

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	171M00000X	Case Manager/Care Coordinator
2	124Q00000X	Dental Hygienist

General Provider Information

NPI Number	:	1770337552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANO VAZQUEZ DIAZ

Provider Business Mailing Address
First Line	:	3170 CORAL WAY APT 610
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3307
Country	:	US
Telephone Number	:	305-905-0155
Fax Number	:

Provider Business Practice Location Address
First Line	:	3170 CORAL WAY APT 610
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3307
Country	:	US
Telephone Number	:	305-905-0155
Fax Number	:

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

Provider Enumeration Date	:	04/16/2024
Last Update Date	:	02/21/2025

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Directions to “ ADRIANO VAZQUEZ DIAZ ” Practice Location

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