Provider Demographics
NPI:1366863326
Name:VAQUER VILLAZON, YORYANA (MD)
Entity Type:Individual
Prefix:
First Name:YORYANA
Middle Name:
Last Name:VAQUER VILLAZON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YORYANA
Other - Middle Name:
Other - Last Name:VAQUER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6100 BLUE LAGOON DR STE 365
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-7010
Mailing Address - Country:US
Mailing Address - Phone:786-322-7333
Mailing Address - Fax:786-322-7329
Practice Address - Street 1:20001 SW 127TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-5118
Practice Address - Country:US
Practice Address - Phone:305-405-2069
Practice Address - Fax:786-577-4381
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-18
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9345505363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010602300Medicaid