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General NPI Number Information
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NPI Number | 1124858733
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Entity Type | Individual
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Provider Name | ONIX ORTIZ VAZQUEZ
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Gender | Male
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Dates
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Enumeration Date | 08/07/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 3870 SAN JOSE PARK DR
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City | JACKSONVILLE
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State | FL
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Zip | 32217-4613
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Country | US
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Telephone | 888-963-2228
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 13TH ST STE D
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City | COLUMBUS
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State | GA
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Zip | 31901-2246
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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