Denise A Vazquez, PSY.D.

Individual provider Active NPI Clinical Psychologist · Hallandale, FL

NPI 1962640003 · NPPES record last updated Oct 24, 2016

Key facts

NPI
1962640003
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
6300 (FL)
Practice address
1001 North Federal Highway Suite 363
Hallandale, FL 33009-2407
Phone
(954) 228-5603
NPI assigned
Jan 28, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6300FLMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6300 FL Yes

Addresses

Primary practice location

1001 North Federal Highway Suite 363
Hallandale, FL 33009-2407

Mailing address

1001 N Federal Hwy Ste 363
Hallandale, FL 33009-2407
Phone (954) 228-5603

Other identifiers

IdentifierTypeStateIssuer
766810400MedicaidFL

Other providers in Hallandale, FL

All providers in Hallandale, FL · Clinical Psychologist in Florida

Sources for this page

Verify at the official NPI Registry.