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
| License | State | Type | Specialty |
|---|---|---|---|
| 6300 | FL | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 766810400 | Medicaid | FL |
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All providers in Hallandale, FL · Clinical Psychologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.