Provider Demographics
NPI:1164493367
Name:VASQUEZ, ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:
Last Name:VASQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4312
Mailing Address - Country:US
Mailing Address - Phone:256-539-4080
Mailing Address - Fax:256-539-4099
Practice Address - Street 1:930 FRANKLIN ST SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4312
Practice Address - Country:US
Practice Address - Phone:256-539-4080
Practice Address - Fax:256-539-4099
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26063207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL202I063539OtherMEDICARE
AL511-80300OtherBCBS
AL192622Medicaid
AL51522003OtherBCBS
ALP00806855OtherRR MEDICARE
AL112337Medicaid
AL112339Medicaid
AL112342Medicaid
AL112343Medicaid
AL112344Medicaid
AL515-99688OtherBCBS
25-10936OtherUNITED HEALTHCARE
P00140741OtherRAILROAD MEDICARE
AL112345Medicaid
AL510-49301OtherBCBS
AL510-49700OtherBCBS
7596496OtherAETNA
AL009958055Medicaid
TN4093520OtherBCBS
AL112344Medicaid
AL112342Medicaid