Provider Demographics
NPI:1427192905
Name:VAZQUEZ, MARIA OLIMPIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:OLIMPIA
Last Name:VAZQUEZ
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 1:1752 N MERRICK DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-4951
Mailing Address - Country:US
Mailing Address - Phone:386-789-1859
Mailing Address - Fax:
Practice Address - Street 1:2800 GRAYTON ST
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-1302
Practice Address - Country:US
Practice Address - Phone:386-532-7034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide