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Organization

GUILLERMO VAZQUEZ M.D. PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GUILLERMO VAZQUEZ M.D. (PRESIDENT)
(305) 557-5355
Entity
Organization

Contact information

Practice address
1435 W 49TH PL, SUITE 206, HIALEAH, FL 33012-3197
(305) 557-5355
(305) 557-5146
Mailing address
PO BOX 832587, MIAMI, FL 33283-2587
(305) 557-5355
(305) 557-5146

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
042997
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04120
MEDICARE NUMBER
FL
05
046912200
FL
Enumeration date
01/24/2011
Last updated
01/24/2011
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