Provider Demographics
NPI:1013407717
Name:PAREDES VASQUEZ, JUAN ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:ANTONIO
Last Name:PAREDES VASQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:145 W 23RD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2858
Mailing Address - Country:US
Mailing Address - Phone:814-452-1142
Mailing Address - Fax:814-452-1255
Practice Address - Street 1:145 W 23RD ST STE 101
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2858
Practice Address - Country:US
Practice Address - Phone:814-452-1142
Practice Address - Fax:814-452-1255
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD484004208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery