Individual
LUIS ANTONIO IVAN VAZQUEZ ZUBILLAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1203 AVE MUNOZ RIVERA, PONCE, PR 00717-0634
(787) 238-2164
Mailing address
PO BOX 190152, SAN JUAN, PR 00919-0152
(787) 238-2164
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
21276
PR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
021276
PR
207RN0300X
Nephrology Physician
Primary
021276
PR
390200000X
Student in an Organized Health Care Education/Training Program
31694-R
PR
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
06/19/2015
Last updated
08/23/2022
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