Individual
VIDAL VAZQUEZ SANTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1519 PONCE DE LEON AVE. PDA.23, SUITE 1105 FIRST BANK BUILDING, SANTURCE, PR 00910
(787) 977-0707
(787) 977-0708
Mailing address
PO BOX 363003, SAN JUAN, PR 00936-3003
(787) 977-0707
(787) 977-0708
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
8049
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
066905
CRUZ AZUL PROVIDER ID
PR
01
—
1688
PMC PROVIDER ID
PR
01
—
220192
PREFERRED HEALTH PROV ID
PR
01
—
3156
AHP PROVIDER ID
PR
01
—
4508049
UIA PROVIDER ID
PR
01
—
80019
TRIPLE S PROVIDER ID
PR
01
—
992650
MMM PROVIDER ID
PR
01
—
N121
IMC PROVIDER ID
PR
Enumeration date
08/16/2006
Last updated
11/30/2010
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