MEDICARE: DR. REINALDO VAZQUEZ 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	5932	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1224099	OTHER	PR	CMS

General Provider Information

NPI Number	:	1881699569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REINALDO VAZQUEZ M. D.

Provider Business Mailing Address
First Line	:	PO BOX 250432
Second Line	:
City	:	AGUADILLA
State	:	PR
Zip	:	00604-0432
Country	:	US
Telephone Number	:	787-890-0085
Fax Number	:	787-890-0085

Provider Business Practice Location Address
First Line	:	CARR. 110 KM. 8.8
Second Line	:
City	:	AGUADILLA
State	:	PR
Zip	:	00603-0000
Country	:	US
Telephone Number	:	787-890-0085
Fax Number	:	787-890-0085

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. REINALDO VAZQUEZ M. D.” Practice Location

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