Individual
ENRIQUE DEJESUS VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1905 NW 82ND AVE, DORAL, FL 33126-1011
(786) 260-0160
(305) 406-9478
Mailing address
11031 NE 6TH AVE, MIAMI, FL 33161-7182
(305) 398-6100
(305) 757-4465
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
762800500
—
FL
Enumeration date
05/03/2007
Last updated
07/12/2012
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