Provider Demographics
NPI:1013399138
Name:RODRIGUEZ VAZQUEZ, NATALIA L (MD)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:L
Last Name:RODRIGUEZ VAZQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 CALLE VILLAMIL APT 1004
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-2832
Mailing Address - Country:US
Mailing Address - Phone:787-209-0050
Mailing Address - Fax:
Practice Address - Street 1:OFC DRA NATALIA L RODRIGUEZ VAZQUEZ CARR 189 KM 2
Practice Address - Street 2:PARQUE INDUSTRIAL CAGUAX
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-209-0050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19897208000000X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics