Individual
NELLY F VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12555 ORANGE DR, SUITE 222, DAVIE, FL 33330
(954) 862-1707
Mailing address
10600 NW 6TH ST, PEMBROKE PINES, FL 33026
(954) 295-8703
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001716800
—
FL
Enumeration date
12/27/2010
Last updated
12/27/2010
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