Healthcare Provider Details

I. General information

NPI: 1992454698
Provider Name (Legal Business Name): AURA YAMILETH ZAPATA VASQUEZ SR. BACB759367
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ALBIN LN
ORLANDO FL
32817-5133
US

IV. Provider business mailing address

3000 ALBIN LN
ORLANDO FL
32817-5133
US

V. Phone/Fax

Practice location:
  • Phone: 407-775-9899
  • Fax:
Mailing address:
  • Phone: 407-775-9899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-116493
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: