MEDICARE: DR. CIRO ANTONIO VASQUEZ 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	207T00000X	Neurological Surgery Physician	54307	MN
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207T00000X	Neurological Surgery Physician	DR.0057130	CO

General Provider Information

NPI Number	:	1952537862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CIRO ANTONIO VASQUEZ M.D

Provider Business Mailing Address
First Line	:	420 DELAWARE ST SE
Second Line	:	MCC 96
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55455-0341
Country	:	US
Telephone Number	:	813-810-8801
Fax Number	:

Provider Business Practice Location Address
First Line	:	913 E 26TH ST
Second Line	:	STE 305 PIPER BLDG
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-4515
Country	:	US
Telephone Number	:	612-871-7278
Fax Number	:	612-863-8531

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

Provider Enumeration Date	:	06/05/2009
Last Update Date	:	01/29/2026

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