Provider Demographics
NPI:1669562112
Name:CENTRO-GINECO OBSTETRICO DR LUIS E. VAZQUEZ ZAYAS C.S.P.
Entity type:Organization
Organization Name:CENTRO-GINECO OBSTETRICO DR LUIS E. VAZQUEZ ZAYAS C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:DR. LUIS E.
Authorized Official - Middle Name:E
Authorized Official - Last Name:VAZQUEZ ZAYAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-752-1490
Mailing Address - Street 1:PO BOX 3177
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-3177
Mailing Address - Country:US
Mailing Address - Phone:787-620-1150
Mailing Address - Fax:787-620-1152
Practice Address - Street 1:EDIF. LORENZO VIZCARRONDO C-1, CALLE IGNACIO ARZUAGA
Practice Address - Street 2:ESQ. MUNOZ RIVERA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-752-1490
Practice Address - Fax:787-620-1152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5859207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0090379BMedicare PIN