Provider Demographics
NPI:1134806961
Name:VAZQUEZ ORTIZ, JULIEANA MARIE
Entity type:Individual
Prefix:
First Name:JULIEANA
Middle Name:MARIE
Last Name:VAZQUEZ ORTIZ
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:HC 2 BOX 5740
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751-9601
Mailing Address - Country:US
Mailing Address - Phone:787-601-0579
Mailing Address - Fax:
Practice Address - Street 1:AVE LOS VETERANOS EDIFICIO GUAYAMA MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-9601
Practice Address - Country:US
Practice Address - Phone:787-378-1432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6449103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling