Provider Demographics
NPI:1275144974
Name:CARDENAS-VAZQUEZ, MARIA D (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:CARDENAS-VAZQUEZ
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24850 SW 119TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-4316
Mailing Address - Country:US
Mailing Address - Phone:305-244-6164
Mailing Address - Fax:
Practice Address - Street 1:24850 SW 119TH AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-4316
Practice Address - Country:US
Practice Address - Phone:305-244-6164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11008649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily