Individual
YUDITH VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10776 NW 83RD TER UNIT 4, DORAL, FL 33178-1692
(305) 308-4696
Mailing address
630 W 36TH ST, HIALEAH, FL 33012-5136
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020453200
—
FL
Enumeration date
03/31/2017
Last updated
07/18/2019
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