Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | ACN555 | FL |
NPI | 1013950682 |
---|---|
Provider Name | Dr. Maria De Las Mercedes Vazquez Torres |
First Address | Leesburg, FL 34748-4495 |
Second Address | Clermont, FL 34711-7600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 30/11/2021 |