Individual provider Active NPI

Maribel Victoria Vazquez, O.D.

  • Optometrist
  • Ponce, PR
National Provider Identifier
1780809426
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
421 Issued in PR
Practice address
503 Calle Ramos Antonini
Suite 1
Ponce, PR 00728-4812
Phone
(787) 259-4361
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 421 PR Primary

Addresses

Primary practice location

503 Calle Ramos Antonini
Suite 1
Ponce, PR 00728-4812

Mailing address

503 Calle Ramos Antonini
Suite 1
Ponce, PR 00728-4812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240719003621 PR Practitioner - Optometry 0244776748 Practice locations: Ponce, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
421PRMDRegistered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780809426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 CALLE RAMOS ANTONINI",
            "address_2": "SUITE 1",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007284812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 CALLE RAMOS ANTONINI",
            "address_2": "SUITE 1",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007284812",
            "telephone_number": "787-259-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "MARIBEL",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.