1255962478 NPI number — MS. ROSA MERCEDES VAZQUEZ PHARMD

Table of content: MS. ROSA MERCEDES VAZQUEZ PHARMD (NPI 1255962478)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255962478 NPI number — MS. ROSA MERCEDES VAZQUEZ PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VAZQUEZ
Provider First Name:
ROSA
Provider Middle Name:
MERCEDES
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255962478
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
EL ALAMO
Provider Second Line Business Mailing Address:
E-6 ALAMO DRIVE
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969-4512
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-790-6051
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR. 862, KM. 1.9
Provider Second Line Business Practice Location Address:
BO. HATO TEJAS
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-269-3140
Provider Business Practice Location Address Fax Number:
787-740-5445
Provider Enumeration Date:
01/27/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  004841 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com