Individual provider · Type 1 NPI
Jesus Ivan Vazquez
Registered Dietetic Technician · Crescent City, FL
Practice location
100 N Lake St
Crescent City, FL 32112-2620
Mailing address
32044 2nd Ave
Deland, FL 32720-4853
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Dietetic Technician Primary | 136A00000X | 86277429 (FL) |
Registered Dietetic Technician: A Dietetic Technician, Registered (DTR)/Nutrition and Dietetics Technician, Registered (NDTR) is an individual holding a nationally protected title issued by the Commission on Dietetic Registration (CDR) to qualified individuals who obtain an associate's degree or higher and successfully complete a sliding set of academic, examination, and practice requirements accredited by the Accreditation Council for Education i…
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- Billie Jo RevelsSpeech-Language Pathologist Crescent City, FL NPI 1063246502
- Kylee StoltzfusPhysical Therapy Assistant Crescent City, FL NPI 1194609164
About NPI 1861390676
Jesus Ivan Vazquez's National Provider Identifier is 1861390676, issued on Oct 30, 2026. The primary taxonomy on file is Registered Dietetic Technician (136A00000X), and the practice location is in Crescent City, FL. The record was last updated on Oct 30, 2026.