Provider Demographics
NPI:1619382207
Name:AIRA VAZQUEZ, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:AIRA 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 1:2500 SW 107TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2470
Mailing Address - Country:US
Mailing Address - Phone:305-873-9793
Mailing Address - Fax:
Practice Address - Street 1:2500 SW 107TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2470
Practice Address - Country:US
Practice Address - Phone:305-873-9793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9380875163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health