Provider Demographics
NPI:1558241240
Name:VAZQUEZ RUIZ, RAFAEL ENRIQUE
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:ENRIQUE
Last Name:VAZQUEZ RUIZ
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:URB. LAS MERCEDES
Mailing Address - Street 2:CALLE 11, #46
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751-1617
Mailing Address - Country:US
Mailing Address - Phone:787-579-6744
Mailing Address - Fax:
Practice Address - Street 1:URB. LAS MERCEDES
Practice Address - Street 2:CALLE 11, #46
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751-1617
Practice Address - Country:US
Practice Address - Phone:787-579-6744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR161771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty