Healthcare Provider Details

I. General information

NPI: 1780332841
Provider Name (Legal Business Name): VERONICA CHAVEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2022
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 N MIAMI AVE APT 1117
MIAMI FL
33127-4969
US

IV. Provider business mailing address

2035 N MIAMI AVE APT 1117
MIAMI FL
33127-4969
US

V. Phone/Fax

Practice location:
  • Phone: 786-617-6902
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-86818
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: