Provider Demographics
NPI:1275953531
Name:VAZQUEZ, NATIVIDAD
Entity Type:Individual
Prefix:
First Name:NATIVIDAD
Middle Name:
Last Name:VAZQUEZ
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:E23 CALLE ABACOA
Mailing Address - Street 2:PARQUE LAS HACIENDAS
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-7747
Mailing Address - Country:US
Mailing Address - Phone:787-630-8470
Mailing Address - Fax:
Practice Address - Street 1:E23 CALLE ABACOA
Practice Address - Street 2:PARQUE LAS HACIENDAS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-7747
Practice Address - Country:US
Practice Address - Phone:787-630-8470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18952163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice