Most Relevant Information
Provider Data
| NPI Number: | 1003639378 |
| Provider Name: | ERNESTO JUAN VAZQUEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/05/2024 |
| Last Updated: | 11/05/2024 |
Provider Practice Location
CARR.827 KM 3.6 BO.ORTIZ SEC.RINCON TOA ALTA. RR4 BOX
TOA ALTA
PR
00953
Practice Location Phone/Fax
| Phone: | 7872338493 |
| Fax: |
Provider Mailing Location
RR 4 BOX 26456
TOA ALTA
PR
009539465
Provider Mailing Phone/Fax
| Phone: | 7872338493 |
| Fax: |