Provider Demographics
NPI:1215376660
Name:YANQUEZ, FEDERICO JAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:FEDERICO
Middle Name:JAVIER
Last Name:YANQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FEDERICO
Other - Middle Name:JAVIER
Other - Last Name:YANQUEZ ARENAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:333 N WILMOT RD STE 340
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-2607
Mailing Address - Country:US
Mailing Address - Phone:520-618-5369
Mailing Address - Fax:520-918-3031
Practice Address - Street 1:310 N WILMOT RD STE 204-205
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2618
Practice Address - Country:US
Practice Address - Phone:520-618-5369
Practice Address - Fax:520-918-3031
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ585552086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ58555OtherARIZONA MEDICAL LICENSE