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Individual

VANESSA VASQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
13101 BRUCE B DOWNS BLVD, USF EARLY STEPS, TAMPA, FL 33612-3803
(813) 974-7938
Mailing address
10507 WILLOWBRAE DR, TAMPA, FL 33624-5223
(630) 698-3528

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
2251P0200X
Pediatric Physical Therapist
Primary
PT23431
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT23431
FLORIDA LICENSE
FL
Enumeration date
11/09/2005
Last updated
03/29/2017
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