Provider Demographics
NPI:1497964324
Name:VAZQUEZ-RIVERA, HIMIRCE (MD)
Entity Type:Individual
Prefix:MRS
First Name:HIMIRCE
Middle Name:
Last Name:VAZQUEZ-RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B49 CALLE 8
Mailing Address - Street 2:URB. RIBERAS DEL RIO
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-8818
Mailing Address - Country:US
Mailing Address - Phone:787-307-6724
Mailing Address - Fax:
Practice Address - Street 1:B49 CALLE 8
Practice Address - Street 2:URB. RIBERAS DEL RIO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-8818
Practice Address - Country:US
Practice Address - Phone:787-307-6724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6253174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist