| Doctor Name: | BENJAMIN G VAZQUEZ |
| NPI Number: | 1093918658 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | |
| Business Practice Address: | 14537 W Indian School Rd #700 Goodyear, AZ - 853959243 |
| Business Phone Number: | 6239350247 |
| Business Fax Number: | 6239352209 |
| Mailing Address: | 13943 N 91st Ave, #c-101 PEORIA |
| State: | AZ |
| Postal Code: | 853813629 |
| Phone Number: | 6237609449 |
| Fax Number: | 6239749351 |
| NPI Enumeration Date: | 06/08/2007 |
| NPI Last Update Date: | 01/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |