MEDICARE: DANIELA VAZQUEZ BERMUDEZ

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1255299194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELA VAZQUEZ BERMUDEZ

Provider Business Mailing Address
First Line	:	1030 JANN AVE
Second Line	:
City	:	OPA LOCKA
State	:	FL
Zip	:	33054-3326
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1030 JANN AVE
Second Line	:
City	:	OPA LOCKA
State	:	FL
Zip	:	33054-3326
Country	:	US
Telephone Number	:	628-488-6949
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ DANIELA VAZQUEZ BERMUDEZ ” Practice Location

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