Provider Demographics
NPI:1770606568
Name:VAZQUEZ-TORRES, RAFAEL (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:VAZQUEZ-TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:405 CALLE SAN JACOBO
Mailing Address - Street 2:SAGRADO CORAZON
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4108
Mailing Address - Country:US
Mailing Address - Phone:787-413-4666
Mailing Address - Fax:787-767-3968
Practice Address - Street 1:HOSPITAL INDUSTRIAL-CENTRO MEDICO
Practice Address - Street 2:BO. MONACILLOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-754-2525
Practice Address - Fax:787-767-3968
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR6354207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AV 1817862OtherFEDERAL NARCOTICS LICENSE
PR6354OtherSTATE LICENSE