Provider Demographics
NPI:1336597913
Name:SANTIAGO VAZQUEZ, YARITZA (MD)
Entity Type:Individual
Prefix:DR
First Name:YARITZA
Middle Name:
Last Name:SANTIAGO VAZQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4808
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4808
Mailing Address - Country:US
Mailing Address - Phone:787-710-5835
Mailing Address - Fax:
Practice Address - Street 1:AVE SEVERIANO CUEVAS #47
Practice Address - Street 2:EDIFICIO HERNANDEZ RIVERA
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-710-5835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21685207R00000X, 207RG0300X
PR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program