Healthcare Provider Details

I. General information

NPI: 1225770985
Provider Name (Legal Business Name): VERONICA VAZQUEZ RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7676 SEACOAST DR
PARKLAND FL
33067-0955
US

IV. Provider business mailing address

7676 SEACOAST DR
PARKLAND FL
33067-0955
US

V. Phone/Fax

Practice location:
  • Phone: 813-816-1342
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH22320
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH23477
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: