Provider Demographics
NPI:1386276491
Name:VAZQUEZ LUGO, ALEJANDRO ANDRES
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:ANDRES
Last Name:VAZQUEZ LUGO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 URB LA ALBORADA # C6
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-1571
Mailing Address - Country:US
Mailing Address - Phone:787-918-5064
Mailing Address - Fax:
Practice Address - Street 1:UPR-SOM MEDICAL SCIENCE CAMPUS DR JOSE CELSO BARBOSA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935-0001
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program