Provider Demographics
NPI:1447941141
Name:ACOBE VAZQUEZ, WILLIAM ENRIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ENRIQUE
Last Name:ACOBE VAZQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 800501
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00780-0501
Mailing Address - Country:US
Mailing Address - Phone:787-848-2100
Mailing Address - Fax:
Practice Address - Street 1:300 S LINE AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4606
Practice Address - Country:US
Practice Address - Phone:352-419-5760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23391208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice