Healthcare Provider Details

I. General information

NPI: 1134759822
Provider Name (Legal Business Name): JOMARYS MI VAZQUEZ-ADORNO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2020
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 NW 14TH AVE
MIAMI FL
33125-1692
US

IV. Provider business mailing address

2060 NW 190TH AVE
PEMBROKE PINES FL
33029-3834
US

V. Phone/Fax

Practice location:
  • Phone: 305-325-0470
  • Fax:
Mailing address:
  • Phone: 754-777-2198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA23078
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI3857
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: