Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 5859 | PR |
NPI | 1396950689 |
---|---|
Provider Name | Dr. Luis E Vazquez Zayas |
First Address | Carolina, PR 00984-3177 |
Second Address | Carolina, PR 00984 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 22/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C77578 | (02) | PR |