Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 16870 | FL |
Y | 213EG0000X | General Practice | 16870 | FL |
NPI | 1003933672 |
---|---|
Provider Name | George A Vazquez |
First Address | Miami, FL 33175-5442 |
Second Address | Miami, FL 33156-3171 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 12/03/2019 |