Provider Demographics
NPI:1326324443
Name:GUEVARA VAZQUEZ, VLADIMIR ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:VLADIMIR
Middle Name:ALEJANDRO
Last Name:GUEVARA VAZQUEZ
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 1:7101 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1622
Mailing Address - Country:US
Mailing Address - Phone:786-538-9889
Mailing Address - Fax:
Practice Address - Street 1:1201 N 37TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5414
Practice Address - Country:US
Practice Address - Phone:754-777-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2023-12-06
Deactivation Date:2023-11-06
Deactivation Code:
Reactivation Date:2023-11-14
Provider Licenses
StateLicense IDTaxonomies
FLME1437902084P0800X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty