Provider Demographics
NPI:1689495202
Name:VAZQUEZ DAVILA, YARIELIS
Entity type:Individual
Prefix:
First Name:YARIELIS
Middle Name:
Last Name:VAZQUEZ DAVILA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 TOSCANA DR APT 331
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-3487
Mailing Address - Country:US
Mailing Address - Phone:939-418-7700
Mailing Address - Fax:
Practice Address - Street 1:6050 TOSCANA DR APT 331
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-3487
Practice Address - Country:US
Practice Address - Phone:939-418-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program