Provider Demographics
NPI:1659887867
Name:VAZQUEZ SANCHEZ, MARISOL
Entity Type:Individual
Prefix:
First Name:MARISOL
Middle Name:
Last Name:VAZQUEZ SANCHEZ
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:HC 4 BOX 8157
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703-8839
Mailing Address - Country:US
Mailing Address - Phone:939-332-8983
Mailing Address - Fax:
Practice Address - Street 1:BO SUMIDERO SECTOR SANTA CLARA
Practice Address - Street 2:
Practice Address - City:AGUAS BUENAS
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00703
Practice Address - Country:UM
Practice Address - Phone:787-469-2385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-26
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR008032183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR061299OtherPHARMACY TECNICIAN