Provider Demographics
NPI:1285430140
Name:GARCIA VAZQUEZ, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:GARCIA VAZQUEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CALLE CALAF # 351
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1313
Mailing Address - Country:US
Mailing Address - Phone:407-403-1044
Mailing Address - Fax:
Practice Address - Street 1:400 CALLE CALAF # 351
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1313
Practice Address - Country:US
Practice Address - Phone:407-403-1044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9119822363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant