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Individual

MARIELENA CECILIA VASQUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6600 VAN AALST BLVD BLDG 9250, FORT BENNING, GA 31905-2102
(624) 082-2737
Mailing address
6600 VAN AALST BOULEVARD, MARTIN ARMY COMMUNITY HOSPITAL, FORT BENNING, GA 31905

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
001912
GA
208000000X
Pediatrics Physician
Primary
62790
GA

Other

Enumeration date
04/02/2007
Last updated
12/31/2025
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