Provider Demographics
NPI:1427431923
Name:VAZQUEZ, PATRICIA
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
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 1:13 CALLE 65 INFANTERIA
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667
Mailing Address - Country:US
Mailing Address - Phone:787-899-1693
Mailing Address - Fax:787-899-7770
Practice Address - Street 1:13 CALLE 65 INFANTERIA
Practice Address - Street 2:
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667-2010
Practice Address - Country:US
Practice Address - Phone:787-899-1693
Practice Address - Fax:787-899-7770
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6150183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician