Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 7291 | PR |
NPI | 1003858101 |
---|---|
Provider Name | Dr. Luz E Vazquez Cancel |
First Address | Canovanas, PR 00729-1646 |
Second Address | Canovanas, PR 00729 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AV2799837 | FEDERAL DEA NUMBER (01) | PR |