Basic Information
| Provider Information | |||||||||
| NPI: | 1255962478 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VAZQUEZ | ||||||||
| FirstName: | ROSA | ||||||||
| MiddleName: | MERCEDES | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | EL ALAMO | ||||||||
| Address2: | E-6 ALAMO DRIVE | ||||||||
| City: | GUAYNABO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009694512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877906051 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | CARR. 862, KM. 1.9 | ||||||||
| Address2: | BO. HATO TEJAS | ||||||||
| City: | BAYAMON | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872693140 | ||||||||
| FaxNumber: | 7877405445 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2020 | ||||||||
| LastUpdateDate: | 01/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 004841 | PR | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.