Provider Demographics
NPI:1144912163
Name:VAZQUEZ RUIZ, STEPHANIE (DC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:VAZQUEZ RUIZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 31742
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-9772
Mailing Address - Country:US
Mailing Address - Phone:787-341-9877
Mailing Address - Fax:
Practice Address - Street 1:BO MALPASO CARR 417 KM 1.1
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-341-9877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-26
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR844111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor