| Dibanni Vasquez, MD | |
|
500 Us Highway 1, Lake Park, FL 33403-3598 | |
| (407) 898-2767 | |
| (407) 898-9443 |
| Full Name | Dibanni Vasquez |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 500 Us Highway 1, Lake Park, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124319611 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0214X | Pediatrics - Pediatric Pulmonology | ME109534 (Florida) | Secondary |
| 208000000X | Pediatrics | ME 109534 (Florida) | Primary |
| Entity Name | South Miami Criticare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306878210 PECOS PAC ID: 5092629808 Enrollment ID: O20031117000334 |
| Entity Name | Paragon Emergency Services LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912101650 PECOS PAC ID: 8628153087 Enrollment ID: O20080310000143 |
| Entity Name | Hospital Physician Services of Florida PA |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558718635 PECOS PAC ID: 7012201965 Enrollment ID: O20160816000476 |
| Mailing Address | Practice Location Address |
|---|---|
| Dibanni Vasquez, MD 2660 W Fairbanks Ave, Winter Park, FL 32789-3385 Ph: (407) 898-2767 | Dibanni Vasquez, MD 500 Us Highway 1, Lake Park, FL 33403-3598 Ph: (407) 898-2767 |
Adriana Magallanes-figueroa, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 500 N Federal Hwy, Lake Park, FL 33403 Phone: 407-898-2767 |