MEDICARE: NICOLAS MARTIN VASQUEZ MA.

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1144505207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLAS MARTIN VASQUEZ MA.

Provider Business Mailing Address
First Line	:	1050 SW MACAO AVE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-7251
Country	:	US
Telephone Number	:	772-249-0910
Fax Number	:	772-249-0910

Provider Business Practice Location Address
First Line	:	1050 SW MACAO AVE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-7251
Country	:	US
Telephone Number	:	772-249-0910
Fax Number	:	772-249-0910

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

Provider Enumeration Date	:	10/19/2011
Last Update Date	:	10/19/2011

Similar Medicare Providers

1841153426 — LAUREL ANN WHITE
Practice Location Address:

2641 SE IBIS AVE
PORT ST LUCIE, FL
34952-7251

Practice Phone: 772-335-3603
Practice Fax:

1013064518 — MRS. AMY MICHELLE DOVE ATC
Practice Location Address:

4673 HUNTINGTON DR
PORT HURON, MI
48060-7251

Practice Phone: 810-966-3899
Practice Fax:

1043616485 — NOLA SMITH FNP
Practice Location Address:

58 HARBOR HOMES
PORT WASHINGTON, NY
11050-7251

Practice Phone: 516-526-5416
Practice Fax:

1699418376 — VANEZA PEDRAJA ALFONSO
Practice Location Address:

7251 BOX ELDER DR
PORT RICHEY, FL
34668-6972

Practice Phone: 727-326-2687
Practice Fax:

1588632681 — SERGEY SHUSHUNOV MD
Practice Location Address:

135 W STATION ST
SAINT ANNE, IL
60964-7251

Practice Phone: 815-427-1324
Practice Fax:

1073045340 — IESHA JOSEPH
Practice Location Address:

7251 OLIVE BLVD
SAINT LOUIS, MO
63130-2322

Practice Phone: 314-749-7618
Practice Fax: 314-862-6155

Directions to “ NICOLAS MARTIN VASQUEZ MA.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.