Individual
JOSE F. VAZQUEZ DEFILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15858 SW WARFIELD BLVD, INDIANTOWN, FL 34956-0648
(772) 597-3596
(772) 597-4194
Mailing address
5827 CORPORATE WAY, WEST PALM BEACH, FL 33407-2000
(561) 844-9443
(561) 844-1013
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME47728
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260509100
—
FL
01
—
57966
BCBS PROVIDER #
FL
Enumeration date
03/21/2006
Last updated
12/13/2019
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