Healthcare Provider Details

I. General information

NPI: 1851218937
Provider Name (Legal Business Name): JACQUELINE VAZQUEZ KING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACQUELINE V VAZQUEZ LCSW

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 CAMINO REAL STE 201
BOCA RATON FL
33433-5511
US

IV. Provider business mailing address

7261 SHERIDAN ST STE 340
HOLLYWOOD FL
33024-2726
US

V. Phone/Fax

Practice location:
  • Phone: 561-674-0885
  • Fax: 561-674-0856
Mailing address:
  • Phone: 954-561-6222
  • Fax: 954-990-7650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW26615
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: