Healthcare Provider Details

I. General information

NPI: 1174459317
Provider Name (Legal Business Name): YAQUELIN VANESSA MONTES DE OCA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W CYPRESS CREEK RD STE B106
FT LAUDERDALE FL
33309-1718
US

IV. Provider business mailing address

110 E 9TH CT
HIALEAH FL
33010-5134
US

V. Phone/Fax

Practice location:
  • Phone: 954-514-7569
  • Fax:
Mailing address:
  • Phone: 786-414-9724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW25962
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: