Provider Demographics
NPI:1730950957
Name:NATALI VAZQUEZ, LUIS JAVIER TIMOTEO
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:JAVIER TIMOTEO
Last Name:NATALI VAZQUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 CALLE JOSE ABAD BONILLA
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-7915
Mailing Address - Country:US
Mailing Address - Phone:787-246-8923
Mailing Address - Fax:
Practice Address - Street 1:1702 CALLE JOSE ABAD BONILLA
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-7915
Practice Address - Country:US
Practice Address - Phone:787-246-8923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program