| Lisette Vazquez Do Pa | |
|
909 N Krome Ave Homestead FL 33030-4408 | |
| (786) 243-4100 | |
| (786) 243-4111 |
| Full Name | Lisette Vazquez Do Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 909 N Krome Ave, Homestead, Florida |
| Authorized Official Name and Position | Lisette Vazquez (PRESIDENT) |
| Authorized Official Contact | 7862434100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisette Vazquez Do Pa 5663 Sw 2nd St Miami FL 33134-1019 Ph: (786) 243-4100 | Lisette Vazquez Do Pa 909 N Krome Ave Homestead FL 33030-4408 Ph: (786) 243-4100 |
| NPI Number | 1619016185 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 01/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619016185 | NPI | - | NPPES |
| 7617825 | Other | FL | AETNA |
| 48582 | Other | FL | BCBS |
| 170465 | Other | FL | HUMANA |
| 304927 | Other | FL | AVMED |
| 57338 | Other | FL | NHP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | OS9315 (Florida) | Primary |
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