MEDICARE: ONEIDA 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	103K00000X	Behavior Analyst
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1639600679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ONEIDA VAZQUEZ

Provider Business Mailing Address
First Line	:	5650 W 26TH CT APT 201
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-4783
Country	:	US
Telephone Number	:	786-600-8487
Fax Number	:

Provider Business Practice Location Address
First Line	:	5650 W 26TH CT APT 201
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-4783
Country	:	US
Telephone Number	:	786-600-8487
Fax Number	:

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

Provider Enumeration Date	:	03/22/2017
Last Update Date	:	02/01/2023

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Directions to “ ONEIDA VAZQUEZ ” Practice Location

Language	Start Address	Practice Location

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