Provider Demographics
NPI:1497964878
Name:VAZQUEZ MARTIRENA, JULIA S (MD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:S
Last Name:VAZQUEZ MARTIRENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27 CALLE BALDORIOTY
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-3428
Mailing Address - Country:US
Mailing Address - Phone:787-714-2310
Mailing Address - Fax:787-714-2365
Practice Address - Street 1:27 CALLE BALDORIOTY
Practice Address - Street 2:
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-3428
Practice Address - Country:US
Practice Address - Phone:787-714-2310
Practice Address - Fax:787-714-2365
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13039174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH82028Medicare UPIN