Provider Demographics
NPI:1124260476
Name:VAZQUEZ-MAYSONET, YOLANDA
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:VAZQUEZ-MAYSONET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:H-111 CALLE BAHIA MANSIONES DE CABO ROJO
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-8942
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PLAZA PEREGRINOS LOCAL # 12 CARRETERA # 2
Practice Address - Street 2:
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660
Practice Address - Country:US
Practice Address - Phone:787-849-5400
Practice Address - Fax:787-849-5400
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0634101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional