Individual provider Active NPI

Marla Alejandra Rodriguez Vazquez, MD

  • Dermatology Physician
  • Bayamon, PR
National Provider Identifier
1366029332
Registry record updated Sep 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
24226 Issued in PR
Practice address
66 Calle Santa Cruz Ste 407
Instituto San Pablo
Bayamon, PR 00961-7050
Phone
(939) 202-7600
Fax
(787) 710-7659
NPI assigned
Mar 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 24226 PR Primary

Addresses

Primary practice location

66 Calle Santa Cruz Ste 407
Instituto San Pablo
Bayamon, PR 00961-7050

Mailing address

66 Calle Santa Cruz Ste 407
Instituto San Pablo
Bayamon, PR 00961-7050
Phone (939) 202-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220826002859 NC Order and Referring Only - DermatologyPractitioner - Dermatology 1355725128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24226PRMDDermatology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758931200000",
    "number": "1366029332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 CALLE SANTA CRUZ STE 407",
            "address_2": "INSTITUTO SAN PABLO",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617050",
            "telephone_number": "939-202-7600",
            "fax_number": "787-710-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 CALLE SANTA CRUZ STE 407",
            "address_2": "INSTITUTO SAN PABLO",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617050",
            "telephone_number": "939-202-7600",
            "fax_number": "787-710-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ VAZQUEZ",
        "first_name": "MARLA",
        "middle_name": "ALEJANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2025-09-27",
        "certification_date": "2025-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PR",
            "license": "24226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.