Provider Demographics
NPI:1093947780
Name:ARMY
Entity Type:Organization
Organization Name:ARMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PGY-1/TY
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:M
Authorized Official - Last Name:VAZQUEZ-ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-914-6038
Mailing Address - Street 1:2020 VINEYARD WAY
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-9146
Mailing Address - Country:US
Mailing Address - Phone:787-914-6038
Mailing Address - Fax:
Practice Address - Street 1:202 VINEYARD WAY
Practice Address - Street 2:APT. 601
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809
Practice Address - Country:US
Practice Address - Phone:787-914-6038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital