Healthcare Provider Details

I. General information

NPI: 1821872490
Provider Name (Legal Business Name): ADRIANA YORDANKA VAZQUEZ CABALLERO BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 JILLIAN RD
BRANDON FL
33510-2265
US

IV. Provider business mailing address

1728 JILLIAN RD
BRANDON FL
33510-2265
US

V. Phone/Fax

Practice location:
  • Phone: 813-947-0631
  • Fax:
Mailing address:
  • Phone: 813-947-0631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2846654
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-285439
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: