Provider Demographics
NPI:1609873686
Name:VAZQUEZ RAMOS, ROBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:VAZQUEZ RAMOS
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 250605
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00604-0605
Mailing Address - Country:US
Mailing Address - Phone:787-819-0202
Mailing Address - Fax:787-819-0204
Practice Address - Street 1:24 AVE SEVERIANO CUEVAS
Practice Address - Street 2:AGUADILLA MEDICAL PLAZA SUITE 205
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-5762
Practice Address - Country:US
Practice Address - Phone:787-819-0202
Practice Address - Fax:787-819-0204
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8459208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR81780Medicare ID - Type Unspecified
PRE38613Medicare UPIN