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Individual

OMAR JOSE VAZQUEZ ALICEA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
225 N 1ST ST, LEESBURG, FL 34748-5150
(407) 905-8827
(352) 360-2389
Mailing address
110 S WOODLAND ST, WINTER GARDEN, FL 34787-3546
(407) 905-8827
(407) 905-8998

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
22439
PR

Other

Enumeration date
08/17/2021
Last updated
05/23/2023
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