Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | FV4412817 | FL |
NPI | 1003131749 |
---|---|
Provider Name | Vanessa Vasquez |
First Address | West Palm Beach, FL 33401-3406 |
Second Address | West Palm Beach, FL 33401-3406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2010 |
Last Update Date | 17/03/2018 |