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General NPI Number Information
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NPI Number | 1265585772
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Entity Type | Individual
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Provider Name | WILLIAM A VAZQUEZ PSY.D; MSW
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Gender | Male
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 09/12/2018
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Provider Practice Location Address
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Address Line | 5201 RAYMOND ST RM 432
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City | ORLANDO
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State | FL
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Zip | 32803-8208
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Country | US
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Telephone | 407-646-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 14127 SANCTUARY TERRACE LN UNIT 24-100
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City | ORLANDO
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State | FL
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Zip | 32832-6643
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Country | US
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Telephone | 407-408-6198
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 8480
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License Number State | PR
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