Provider Demographics
NPI:1225034747
Name:VAZQUEZ COLON, JOSE E (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:E
Last Name:VAZQUEZ COLON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE RANADA, NE-1
Mailing Address - Street 2:MANSION DEL RIO
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00963
Mailing Address - Country:US
Mailing Address - Phone:787-268-7011
Mailing Address - Fax:787-268-7011
Practice Address - Street 1:1663 AVE. FERNANDEZ JUNCOS
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-268-7011
Practice Address - Fax:787-268-7011
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR074034OtherLA CRUZ AZUL DE PUERTO RI
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PRCP-1040OtherPALIC, PUERTO RICO
PR73539OtherTRIPLE S, PUERTO RICO
PR9090104OtherHUMANA, PUERTO RICO