Provider Demographics
NPI:1407061674
Name:VAZQUEZ, MARIBEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIBEL
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PIDGEON HILL DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6145
Mailing Address - Country:US
Mailing Address - Phone:703-404-1807
Mailing Address - Fax:703-404-1827
Practice Address - Street 1:2 PIDGEON HILL DR
Practice Address - Street 2:SUITE 280
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6149
Practice Address - Country:US
Practice Address - Phone:703-404-1807
Practice Address - Fax:703-404-1827
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555757111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350001101Medicare PIN
VA350001101Medicare ID - Type Unspecified