Provider Demographics
NPI:1538020789
Name:VAZQUEZ, ALEJANDRA VALENTINA
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:VALENTINA
Last Name:VAZQUEZ
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 1:745 SE 16TH CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33034-5681
Mailing Address - Country:US
Mailing Address - Phone:305-206-5660
Mailing Address - Fax:
Practice Address - Street 1:745 SE 16TH CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33034-5681
Practice Address - Country:US
Practice Address - Phone:305-206-5660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician