Individual
DR. IDEL A VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
SGT. LUIS MEDINA ST. #361, EXT. ROOSEVELT, SAN JUAN, PR 00918
(787) 484-5643
(787) 259-9156
Mailing address
138 AVE WINSTON CHURCHILL, SAN JUAN, PR 00926-6013
(787) 840-1053
(787) 844-4189
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
16214
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16214
STATE LICENSE TEM
PR
Enumeration date
10/02/2006
Last updated
03/07/2023
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