Provider Demographics
NPI:1467043463
Name:VAZQUEZ RUIZ, MAGNELIA NICOLASA (NP)
Entity type:Individual
Prefix:MRS
First Name:MAGNELIA
Middle Name:NICOLASA
Last Name:VAZQUEZ RUIZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9565 SW 24TH ST APT H112
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-8024
Mailing Address - Country:US
Mailing Address - Phone:786-857-2379
Mailing Address - Fax:
Practice Address - Street 1:4800 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2523
Practice Address - Country:US
Practice Address - Phone:305-264-5154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011364363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily