Basic Information
| Provider Information | |||||||||
| NPI: | 1629305537 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | VAZ | ||||||||
| FirstName: | SANDRA | ||||||||
| MiddleName: | YVETTE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1801 LEE RD STE 165 | ||||||||
| Address2: | |||||||||
| City: | WINTER PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327892127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4079750410 | ||||||||
| FaxNumber: | 4079750411 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 E ROLLINS ST | ||||||||
| Address2: | FLORIDA HOSPITAL PEDIATRIC INTENSIVISTS | ||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328031248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4079750410 | ||||||||
| FaxNumber: | 4079750411 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2009 | ||||||||
| LastUpdateDate: | 03/09/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0203X | 249704 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine | 2080P0203X | ME111248 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine |
No ID Information.