Provider Demographics
NPI:1447220165
Name:VAZQUEZ -TORRES, ELSIE E (MD)
Entity type:Individual
Prefix:
First Name:ELSIE
Middle Name:E
Last Name:VAZQUEZ -TORRES
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:54 CALLE BALBOA
Mailing Address - Street 2:URB. CABRERA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925-2411
Mailing Address - Country:US
Mailing Address - Phone:787-765-1578
Mailing Address - Fax:787-765-1578
Practice Address - Street 1:252 CALLE SAN JORGE
Practice Address - Street 2:SAN JORGE MEDICAL OFFICE SUIT 406
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912-3310
Practice Address - Country:US
Practice Address - Phone:787-726-0210
Practice Address - Fax:787-728-5136
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13744208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics