Provider Demographics
NPI:1235942103
Name:VAZQUEZ, AIDILOTSIVETTE
Entity type:Individual
Prefix:MISS
First Name:AIDILOTSIVETTE
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLA CAROLINA 104-13 CALLE 104
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-4262
Mailing Address - Country:US
Mailing Address - Phone:787-512-0906
Mailing Address - Fax:
Practice Address - Street 1:RIO PIEDRAS MEDICAL CENTER, ANTIGUA CASA DE SALUD
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00985-4262
Practice Address - Country:US
Practice Address - Phone:787-763-7521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1698101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor