Individual
SUSAN MACIE VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, APRN, PMHNP
Contact information
Practice address
255 S ORANGE AVE STE 104, ORLANDO, FL 32801-3411
(407) 720-5900
Mailing address
255 S ORANGE AVE STE 104, ORLANDO, FL 32801-3411
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11029294
FL
Other
Enumeration date
10/26/2023
Last updated
04/12/2024
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