Provider Demographics
NPI:1376072249
Name:VAPOR-CUI, VICTOR (APRN)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:
Last Name:VAPOR-CUI
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:VICTOR
Other - Middle Name:REY
Other - Last Name:VAPOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, APRN
Mailing Address - Street 1:12056 SCARSDALE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-9331
Mailing Address - Country:US
Mailing Address - Phone:904-400-2960
Mailing Address - Fax:
Practice Address - Street 1:12056 SCARSDALE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-9331
Practice Address - Country:US
Practice Address - Phone:904-400-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-05
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV828427363LA2200X
FLAPRN9376012363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health