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General NPI Number Information
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NPI Number | 1265123277
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Entity Type | Individual
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Provider Name | JULIA BESSIE VASQUEZ LDO
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Gender | Female
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 5571 W HILLSBORO BLVD
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City | COCONUT CREEK
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State | FL
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Zip | 33073-4376
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Country | US
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Telephone | 954-426-6199
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Fax | 954-426-6168
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Provider Business Mailing Address
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Address Line | 23313 SW 61ST AVE
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City | BOCA RATON
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State | FL
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Zip | 33428-2023
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Country | US
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Telephone | 954-826-8393
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | DO7059
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License Number State | FL
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