Provider Demographics
NPI:1194609222
Name:VAZQUEZ ACOSTA, MAURA
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:
Last Name:VAZQUEZ ACOSTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15419 SW 85TH LN # 198
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1258
Mailing Address - Country:US
Mailing Address - Phone:305-990-4471
Mailing Address - Fax:
Practice Address - Street 1:6001 NW 153RD ST STE 160
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2453
Practice Address - Country:US
Practice Address - Phone:786-384-4990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician