Provider Demographics
NPI:1992454698
Name:ZAPATA VASQUEZ, AURA YAMILETH SR (BACB759367)
Entity type:Individual
Prefix:
First Name:AURA
Middle Name:YAMILETH
Last Name:ZAPATA VASQUEZ
Suffix:SR
Gender:F
Credentials:BACB759367
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 ALBIN LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-5133
Mailing Address - Country:US
Mailing Address - Phone:407-775-9899
Mailing Address - Fax:
Practice Address - Street 1:3000 ALBIN LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-5133
Practice Address - Country:US
Practice Address - Phone:407-775-9899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-116493106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113505000Medicaid