Susana Michelle Vazquez Nieves, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY9861 Issued in FL

Practice address

5270 Babcock St NE Ste 1
Palm Bay, FL 32905-4616

Phone

(321) 722-6301

Fax

(321) 722-5960

NPI assigned

Feb 5, 2013

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083953434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329021137",
            "telephone_number": "321-952-9696",
            "fax_number": "321-952-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5270 BABCOCK ST NE STE 1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054616",
            "telephone_number": "321-722-6301",
            "fax_number": "321-722-5960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4655 Caverns Dr",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347582504",
            "country_code": "US",
            "telephone_number": "787-605-8395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4655 Caverns Dr",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347582504",
            "country_code": "US",
            "telephone_number": "787-605-8395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZQUEZ NIEVES",
        "first_name": "SUSANA",
        "middle_name": "MICHELLE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY9861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Valle, MD
• Angelica Maria Vargas, MA, CJ
• Shery Mathew Varghese, M.D.
• Cheryl Ann Vaughn, RN
• Mark Vaughn, DPM
• Jasmine Nichole Vazquez
• Tammy Vega
• Karol Tatiana Velasquez
• Jessica Velez Tiru
• Lori Velez

• Psychologist in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.