Provider Demographics
NPI:1942581079
Name:SANTIAGO VAZQUEZ, TERESITA (RPT)
Entity Type:Individual
Prefix:MRS
First Name:TERESITA
Middle Name:
Last Name:SANTIAGO VAZQUEZ
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CALLE LUIS M ALFARO
Mailing Address - Street 2:
Mailing Address - City:OROCOVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00720-4410
Mailing Address - Country:US
Mailing Address - Phone:787-615-5443
Mailing Address - Fax:
Practice Address - Street 1:CALLE LUIS M. ALFARO #10
Practice Address - Street 2:
Practice Address - City:OROCOVIS
Practice Address - State:PR
Practice Address - Zip Code:00720-0250
Practice Address - Country:US
Practice Address - Phone:787-615-5443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR885225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist