Healthcare Provider Details

I. General information

NPI: 1265341051
Provider Name (Legal Business Name): SPIRIT OF COMPASSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6506 DORIS DR
FORT PIERCE FL
34951-3417
US

IV. Provider business mailing address

4888 N KINGS HWY # 104
FORT PIERCE FL
34951-2244
US

V. Phone/Fax

Practice location:
  • Phone: 954-496-1500
  • Fax:
Mailing address:
  • Phone: 954-496-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. SANTIAGO C VAZQUEZ JR.
Title or Position: CEO
Credential: CRRA, MHFA
Phone: 954-234-3414