Provider Demographics
NPI:1194569483
Name:GONZALEZ VAZQUEZ, OSBEL
Entity type:Individual
Prefix:
First Name:OSBEL
Middle Name:
Last Name:GONZALEZ VAZQUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5935 FOREST HILL BLVD APT 7
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-5563
Mailing Address - Country:US
Mailing Address - Phone:561-603-5577
Mailing Address - Fax:
Practice Address - Street 1:2001 PALM BCH LK BLVD STE 300Q
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6510
Practice Address - Country:US
Practice Address - Phone:561-260-6871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician