Individual
LUIS VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3267 S 16TH ST, SUITE 209, MILWAUKEE, WI 53215-4500
(414) 389-3111
(414) 389-3110
Mailing address
3267 S 16TH ST, SUITE 209, MILWAUKEE, WI 53215-4500
(414) 389-3111
(414) 389-3110
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
45564020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34374200
—
WI
Enumeration date
06/07/2006
Last updated
07/08/2007
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