Provider Demographics
NPI:1457513590
Name:VAZQUEZ, ADRIAN (MD)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 VANDERBILT PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2476
Mailing Address - Country:US
Mailing Address - Phone:828-258-9533
Mailing Address - Fax:828-253-4434
Practice Address - Street 1:4 VANDERBILT PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2476
Practice Address - Country:US
Practice Address - Phone:828-258-9533
Practice Address - Fax:828-253-4434
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-00865207RR0500X
FLME115885207RR0500X
FLTRN12517207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009074600Medicaid
NC19D5LOtherBCBS OF NC
NCP01517860OtherRR MEDICARE
NCP01517860OtherRR MEDICARE
NCNC0627AMedicare PIN