Provider Demographics
NPI:1811384753
Name:VAZQUEZ ORTIZ, OSCAR RAFAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:RAFAEL
Last Name:VAZQUEZ ORTIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1477 ASHFORD AVE
Mailing Address - Street 2:APT 4B
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907
Mailing Address - Country:US
Mailing Address - Phone:787-557-3435
Mailing Address - Fax:
Practice Address - Street 1:431 CALLE ATENEA
Practice Address - Street 2:URB. MONTE OLIVO
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-6648
Practice Address - Country:US
Practice Address - Phone:787-557-3435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-17
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21323207U00000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine