Healthcare Provider Details

I. General information

NPI: 1407471972
Provider Name (Legal Business Name): BESSY ARIANA VASQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 05/07/2021
Certification Date: 05/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 TAMIAMI TRL N STE B
NAPLES FL
34103-2853
US

IV. Provider business mailing address

3020 TERRACAP WAY APT 4107
ESTERO FL
33928-4450
US

V. Phone/Fax

Practice location:
  • Phone: 239-351-0675
  • Fax:
Mailing address:
  • Phone: 786-512-7039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT20801
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: