Provider Demographics
NPI:1922531540
Name:VAZQUEZ FIGUEROA, MONICA (OTA 17458)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:VAZQUEZ FIGUEROA
Suffix:
Gender:F
Credentials:OTA 17458
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 W 76TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1834
Mailing Address - Country:US
Mailing Address - Phone:786-773-3393
Mailing Address - Fax:
Practice Address - Street 1:845 W 75TH ST APT 302
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4089
Practice Address - Country:US
Practice Address - Phone:786-438-8178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLOTA17458224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOTA17458OtherOCCUPATIONAL THERAPY ASSISTANT