| Doctor Name: | KIMBER VASQUEZ |
| NPI Number: | 1689803330 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | ACN293 |
| Business Practice Address: | 950 County Road 17a W Avon Park, FL - 338252164 |
| Business Phone Number: | 8634523000 |
| Business Fax Number: | 8634523077 |
| Mailing Address: | 950 County Road 17a W, AVON PARK |
| State: | FL |
| Postal Code: | 338252164 |
| Phone Number: | 8634523000 |
| Fax Number: | 8634523069 |
| NPI Enumeration Date: | 07/02/2009 |
| NPI Last Update Date: | 07/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ACN293 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |