Provider Demographics
NPI:1538666581
Name:VAZQUEZ, MARIA LOURDES
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LOURDES
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:662 W 30TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5331
Mailing Address - Country:US
Mailing Address - Phone:786-357-0540
Mailing Address - Fax:
Practice Address - Street 1:12595 SW 137TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4218
Practice Address - Country:US
Practice Address - Phone:305-662-6652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other