Provider Demographics
NPI:1437253887
Name:CASABLANCA VAZQUEZ, CARMEN J (OPTOMETRY DOCTOR)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:J
Last Name:CASABLANCA VAZQUEZ
Suffix:
Gender:F
Credentials:OPTOMETRY DOCTOR
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Mailing Address - Street 1:PASEO DE LA REINA ST. #J-3
Mailing Address - Street 2:MANSIONES REALES
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-789-5429
Mailing Address - Fax:787-789-5429
Practice Address - Street 1:29 CALLE WASHINGTON
Practice Address - Street 2:SUITE 407 ASHFORD MEDICAL CENTER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1510
Practice Address - Country:US
Practice Address - Phone:787-963-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2016-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR00204/0038152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management