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Individual

EDUARDO MANUEL VAZQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
4031 UPPER CREEK DR, SUN CITY CENTER, FL 33573-6819
(813) 633-2733
Mailing address
4031 UPPER CREEK DR, SUN CITY CENTER, FL 33573-6819
(813) 633-2733

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9102376
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
292832900
FL
Enumeration date
06/21/2006
Last updated
11/01/2011
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