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NPI Code Detail

MEDICARE: CARLA ROSSOTTI VAZQUEZ,MD,PSC

MEDICARE: CARLA ROSSOTTI VAZQUEZ,MD,PSC
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
1208D00000XGeneral Practice Physician17559PR

General Provider Information

NPI Number : 1932531480
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARLA ROSSOTTI VAZQUEZ,MD,PSC
Provider Business Mailing Address
First Line : 1511 AVE PONCE DE LEON
Second Line : TORRE PLAZA SAN MATEO 500 APT 521
City : SAN JUAN
State : PR
Zip : 00909-5001
Country : US
Telephone Number : 787-242-7306
Fax Number :
Provider Business Practice Location Address
First Line : 1511 AVE PONCE DE LEON
Second Line : TORRE PLAZA SAN MATEO 500 APT 521
City : SAN JUAN
State : PR
Zip : 00909-5001
Country : US
Telephone Number : 787-242-7306
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : CARLA A ROSSOTTI
Credential : MD
Telephone Number : 787-242-7306
Provider Enumeration Date : 08/07/2013
Last Update Date : 08/07/2013

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