Individual
KENNETH SHAQUILLE VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 AVE LAUREL, BAYAMON, PR 00956-4816
(787) 579-5581
Mailing address
CARR #2 KM 8.2 JUAN SANCHEZ, BAYAMON, PR 00960
(787) 579-5581
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/22/2023
Last updated
03/22/2023
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