Individual
MRS. SUSANA VAZQUEZ LUGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
AVE. DOMENECH 207, OFICINA 108, HATO REY, PR 00918
(787) 274-5100
(787) 274-5115
Mailing address
2000 CARR 8177, SUITE 26 PMB 138, GUAYNABO, PR 00966-3733
(787) 640-6585
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1831
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100572
CRUZ AZUL
—
01
—
2581
REFORMA
—
01
—
2611
PPO
—
01
—
HM0LPOS2611
APS
—
Enumeration date
10/14/2005
Last updated
01/13/2011
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