Individual
ISMAEL VAZQUEZ CISNEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1297 US 27 N, LAKE PLACID, FL 33852-7907
(863) 465-0568
Mailing address
1297 US 27 N, LAKE PLACID, FL 33852-7907
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA29705
FL
Other
Enumeration date
03/11/2025
Last updated
03/11/2025
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