MEDICARE: GLADYS DE LA CARIDAD VAZQUEZ CALDERIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-24-390086	FL

General Provider Information

NPI Number	:	1992511372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLADYS DE LA CARIDAD VAZQUEZ CALDERIN

Provider Business Mailing Address
First Line	:	7927 EAST DR APT 268
Second Line	:
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141-3318
Country	:	US
Telephone Number	:	305-492-5722
Fax Number	:

Provider Business Practice Location Address
First Line	:	7927 EAST DR APT 268
Second Line	:
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141-3318
Country	:	US
Telephone Number	:	305-492-5722
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2024
Last Update Date	:	12/10/2024

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Directions to “ GLADYS DE LA CARIDAD VAZQUEZ CALDERIN ” Practice Location

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