Organization
BERNICE VAZQUEZ, PSY.D.; LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNICE VAZQUEZ GARAY PSY.D. (OWNER)
(321) 430-7017
Entity
Organization
Contact information
Practice address
5728 MAJOR BLVD STE 222, ORLANDO, FL 32819-7969
(321) 430-7017
Mailing address
5728 MAJOR BLVD STE 222, ORLANDO, FL 32819-7969
(321) 430-7017
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY9271
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841505195
NPI
FL
Enumeration date
09/21/2015
Last updated
09/21/2015
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