Provider Demographics
NPI:1568171544
Name:VAZQUEZ TORRES, JESUS EMMANUEL
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:EMMANUEL
Last Name:VAZQUEZ TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 12 BOX 7137
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-9247
Mailing Address - Country:US
Mailing Address - Phone:939-272-2261
Mailing Address - Fax:
Practice Address - Street 1:VA-CARIBBEAN HEALTHCARE SYSTEM 10 CASIA STREET
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3201
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program