Provider Demographics
NPI:1427035963
Name:VAZQUEZ DUBEAU, DAISY (MD)
Entity Type:Individual
Prefix:DR
First Name:DAISY
Middle Name:
Last Name:VAZQUEZ DUBEAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DAISY
Other - Middle Name:
Other - Last Name:VAZQUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 195567
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-5567
Mailing Address - Country:US
Mailing Address - Phone:787-766-1920
Mailing Address - Fax:787-751-3342
Practice Address - Street 1:576 CALLE CESAR GONZALEZ
Practice Address - Street 2:SUITE 401
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3756
Practice Address - Country:US
Practice Address - Phone:787-766-1920
Practice Address - Fax:787-751-3342
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10973207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR83740Medicare ID - Type Unspecified
PRG41086Medicare UPIN