Individual
ENRIQUE XAVIER VACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
525 S HERCULES AVE STE 102, CLEARWATER, FL 33764-6320
(727) 442-6068
Mailing address
13324 FAWN LILY DR, RIVERVIEW, FL 33579-0010
(786) 382-6911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9110684
FL
Other
Enumeration date
06/21/2018
Last updated
09/24/2025
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