Provider Demographics
NPI:1336112572
Name:VAZQUEZ, MARIA JULIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:JULIA
Last Name:VAZQUEZ
Suffix:
Gender:F
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:PO BOX 261
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:PR
Mailing Address - Zip Code:00754-0261
Mailing Address - Country:US
Mailing Address - Phone:787-368-7524
Mailing Address - Fax:787-731-5957
Practice Address - Street 1:31 CALAF ST.
Practice Address - Street 2:MONTEMAR PLAZA 5B
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-282-7788
Practice Address - Fax:787-758-5522
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14617208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9180646OtherHUMANA
PR2011363OtherPREFERRED HEALTH