Provider Demographics
NPI:1922827104
Name:VASQUEZ, EDITH DEL CARMEN (FNP)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:DEL CARMEN
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:EDITH
Other - Middle Name:D
Other - Last Name:VASQUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8930 SW 172ND AVE APT 3401
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-3059
Mailing Address - Country:US
Mailing Address - Phone:305-282-1961
Mailing Address - Fax:
Practice Address - Street 1:8930 SW 172ND AVE APT 3401
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-3059
Practice Address - Country:US
Practice Address - Phone:305-282-1961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11033343363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily