Provider Demographics
NPI:1285368761
Name:VAZQUEZ, JOSE NEGRON JR (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:NEGRON
Last Name:VAZQUEZ
Suffix:JR
Gender:
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 1 BOX 5120
Mailing Address - Street 2:
Mailing Address - City:JAYUYA
Mailing Address - State:PR
Mailing Address - Zip Code:00664-9711
Mailing Address - Country:US
Mailing Address - Phone:787-566-1555
Mailing Address - Fax:
Practice Address - Street 1:BO MAMEYES SECTOR LAS CASITAS
Practice Address - Street 2:CARRETERA 141 KILOMETRO 13.9
Practice Address - City:JAYUYA
Practice Address - State:PR
Practice Address - Zip Code:00664
Practice Address - Country:US
Practice Address - Phone:787-566-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical