MEDICARE: ANGELICA VASQUEZ LA ROSA

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	374U00000X	Home Health Aide		FL

General Provider Information

NPI Number	:	1639027733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA VASQUEZ LA ROSA

Provider Business Mailing Address
First Line	:	835 W 69TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-5211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	835 W 69TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-5211
Country	:	US
Telephone Number	:	786-294-1731
Fax Number	:

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

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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