Basic Information
Provider Information
NPI: 1467079541
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VAZQUEZ RABELO
FirstName: CLAUDIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
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Mailing Information
Address1: 9725 NW 117TH AVE STE 200
Address2:  
City: MEDLEY
State: FL
PostalCode: 331781260
CountryCode: US
TelephoneNumber: 9545149360
FaxNumber:  
Practice Location
Address1: 8967 TAFT ST
Address2:  
City: PEMBROKE PINES
State: FL
PostalCode: 330244648
CountryCode: US
TelephoneNumber: 8552266633
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/06/2020
LastUpdateDate: 07/17/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208D00000XAPRN11007838FLN Allopathic & Osteopathic PhysiciansGeneral Practice 
363LF0000XARNP11007838FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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