Provider Demographics
NPI:1821744046
Name:VAZQUEZ GONZALEZ, GABRIELA ALEXANDRA
Entity Type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:ALEXANDRA
Last Name:VAZQUEZ GONZALEZ
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:CARRETERA 3 KM. 8.3
Mailing Address - Street 2:AVE 65 DE INFANTERIA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 3 KM. 8.3
Practice Address - Street 2:AVE 65 DE INFANTERIA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00984
Practice Address - Country:US
Practice Address - Phone:787-757-1800
Practice Address - Fax:787-276-2205
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR34911223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry