Provider Demographics
NPI:1720154750
Name:VAZQUEZ PEREZ, GILBERTO (MD)
Entity Type:Individual
Prefix:MR
First Name:GILBERTO
Middle Name:
Last Name:VAZQUEZ PEREZ
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:HC 72 BOX 3951
Mailing Address - Street 2:D1
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-8771
Mailing Address - Country:US
Mailing Address - Phone:787-869-4721
Mailing Address - Fax:787-869-0536
Practice Address - Street 1:CARR 803 KM 8.9
Practice Address - Street 2:BO CEDRO ARRIBA
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-8771
Practice Address - Country:US
Practice Address - Phone:787-869-4721
Practice Address - Fax:787-869-0536
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11436208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
080106OtherLA CRUZ AZUL DE PR
26781OtherASOCIACION DE MAESTROS
87628OtherMEDICARE OPTIMO
87628OtherTRIPLE S
03946OtherAMERICAN HEALTH
2011407OtherPREFERRED HEALTH
400288OtherMEDICARE Y MUCHO MAS
400288OtherMEDICARE Y MUCHO MAS
87628OtherTRIPLE S