Individual
ERIC VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1207 N CENTRAL AVE, KISSIMMEE, FL 34741-4407
(407) 508-7802
Mailing address
3702 CROSSING CREEK BLVD, SAINT CLOUD, FL 34772-7023
(407) 340-1927
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
29008
FL
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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