Provider Demographics
NPI:1821457342
Name:VAZQUEZ, AMBER BETH (APRN)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:BETH
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:BETH
Other - Last Name:HERSCHBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:16203 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1208
Mailing Address - Country:US
Mailing Address - Phone:727-743-8039
Mailing Address - Fax:
Practice Address - Street 1:12902 USF MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-9416
Practice Address - Country:US
Practice Address - Phone:813-745-4673
Practice Address - Fax:813-745-6814
Is Sole Proprietor?:No
Enumeration Date:2016-02-11
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9190194363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily