Provider Demographics
NPI:1194461749
Name:VAZQUEZ DIAZ, YADIRIS
Entity Type:Individual
Prefix:
First Name:YADIRIS
Middle Name:
Last Name:VAZQUEZ DIAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-0214
Mailing Address - Country:US
Mailing Address - Phone:939-257-4821
Mailing Address - Fax:
Practice Address - Street 1:CARR 771 KM 5.5
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-0214
Practice Address - Country:US
Practice Address - Phone:939-257-4821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program