MEDICARE: ALEJANDRO C VAZQUEZ

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	BACB1432931	FL

General Provider Information

NPI Number	:	1285596510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO C VAZQUEZ

Provider Business Mailing Address
First Line	:	6361 PRESIDENTIAL CT STE C-111
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3543
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6361 PRESIDENTIAL CT STE C-111
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3543
Country	:	US
Telephone Number	:	305-204-3264
Fax Number	:

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

Provider Enumeration Date	:	11/25/2025
Last Update Date	:	11/25/2025

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Directions to “ ALEJANDRO C VAZQUEZ ” Practice Location

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