| Viviana Smith Vazquez, MD | |
| 
					155 Bartram Market Dr Ste 120, St Johns, FL 32259-4582  | |
| (904) 650-2193 | |
| (904) 201-6350 | 
| Full Name | Viviana Smith Vazquez | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 155 Bartram Market Dr Ste 120, St Johns, Florida | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1740546142 | NPI | - | NPPES | 
| 102072000 | Medicaid | FL | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | MD454462 (Pennsylvania) | Secondary | 
| 208000000X | Pediatrics | ME139341 (Florida) | Primary | 
| Entity Name | University Of Florida Jacksonville Physicians, Inc. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1144276452 PECOS PAC ID: 9133025869 Enrollment ID: O20040128000786  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Viviana Smith Vazquez, MD 900 S Pine Island Rd Ste 800, Plantation, FL 33324-3923 Ph: (904) 642-6100  | Viviana Smith Vazquez, MD 155 Bartram Market Dr Ste 120, St Johns, FL 32259-4582 Ph: (904) 650-2193  | 
Dr. Maria Teresa Valdes, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 774 Sr 13 North, Suite 6, St Johns, FL 32259 Phone: 904-786-9600 Fax: 904-786-6036  | |
Dr. Jami S Webster, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2001 County Road 210 W Ste 200, St Johns, FL 32259 Phone: 044-508-1209 Fax: 904-230-1066  | |
Giselle Khadine Habet, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 155 Bartram Market Dr Ste 120, St Johns, FL 32259 Phone: 904-650-2193 Fax: 904-201-6350  |