Healthcare Provider Details

I. General information

NPI: 1699208769
Provider Name (Legal Business Name): CLAUDE VAZQUEZ RBT-15-6
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 09/29/2026
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14138 SW 166TH TER
MIAMI FL
33177-2086
US

IV. Provider business mailing address

14138 SW 166TH TER
MIAMI FL
33177-2086
US

V. Phone/Fax

Practice location:
  • Phone: 786-209-8609
  • Fax:
Mailing address:
  • Phone: 786-209-8609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ11956
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-15-09216
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: