Provider Demographics
NPI:1265324446
Name:VAZQUEZ, LIANA M (MSW, RCSWI)
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:M
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:MSW, RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5735 SW 57TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-2351
Mailing Address - Country:US
Mailing Address - Phone:786-260-7115
Mailing Address - Fax:
Practice Address - Street 1:11055 SW 186TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6840
Practice Address - Country:US
Practice Address - Phone:786-224-6884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW17543104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker