MEDICARE: CHRISTOPHER VASQUEZ MOT, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT 16289	FL

General Provider Information

NPI Number	:	1023437787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER VASQUEZ MOT, OTR/L

Provider Business Mailing Address
First Line	:	12060 SW 129TH CT STE 107
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-4582
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12060 SW 129TH CT STE 107
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-4582
Country	:	US
Telephone Number	:	305-378-5247
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2014
Last Update Date	:	04/10/2014

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