Provider Demographics
NPI:1154418184
Name:VASQUEZ, CRISTINA CANTRES (RPH)
Entity type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:CANTRES
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9128 NW 192ND TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-8409
Mailing Address - Country:US
Mailing Address - Phone:305-829-9518
Mailing Address - Fax:866-896-2435
Practice Address - Street 1:1100 NW 95TH ST
Practice Address - Street 2:PHARMACY
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-2038
Practice Address - Country:US
Practice Address - Phone:305-835-6143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 18231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist