Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

JESUS IVAN VAZQUEZ
NPI 1861390676
Dietetic Technician, Registered in Crescent City, FL

Active since October 30, 2026
100 N LAKE ST, CRESCENT CITY, FL 32112(386) 698-2222 Get Directions Write a Review

NPPES record added: October 30, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Jesus Ivan Vazquez NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESUS IVAN VAZQUEZ (NPI 1861390676) is an individual dietetic technician, registered in Crescent City, Florida, licensed in Florida (86277429) and active in the NPI registry since October 2026.

NPPES Registry Identity

NPI1861390676
Entity TypeIndividualMale
Primary Taxonomy136A00000X
Provider Legal NameJESUS IVAN VAZQUEZ
Location Address100 N LAKE STCrescent City, FL 32112-2620
Mailing Address32044 2nd AveDeland, FL 32720-4853
Sole ProprietorNo
Enumeration DateOctober 30, 2026
NPPES CertifiedOctober 30, 2026
✔ NPI 1861390676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietetic Technician, RegisteredDietary & Nutritional Service Providers
Taxonomy Code136A00000X
License✔ Licensed in FL · 86277429
Definition
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 in Nutrition and Dietetics (ACEND) or established by CDR, the nature of which are dependent upon the level of academic degree obtained. The scope of practice of the NDTR focuses on food, nutrition, and dietetics practice, as well as related services. NDTRs work under the supervision of a Registered Dietitian Nutritionist (RDN) when in direct patient/client nutrition care, and may work independently in providing general nutrition education to healthy populations. Patient/client populations include individuals receiving individualized care who have medical conditions or diseases, as well as at-risk individuals receiving personalized nutrition guidance as part of preventive health care.
100 N LAKE ST, Crescent City, FL 32112

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Speech-Language Pathologist
100 N LAKE ST
CRESCENT CITY, FL 32112
Physical Therapy Assistant
100 N LAKE ST
CRESCENT CITY, FL 32112
Skilled Nursing Facility
100 N LAKE ST
CRESCENT CITY, FL 32112
Skilled Nursing Facility
100 N LAKE ST
CRESCENT CITY, FL 32112
Skilled Nursing Facility
100 N LAKE ST
CRESCENT CITY, FL 32112

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jesus Vazquez's NPI number?

The NPI number for Jesus Vazquez is 1861390676. It was assigned to this individual provider in the NPPES registry on October 30, 2026.

Where is Jesus Vazquez located?

Jesus Vazquez practices at 100 N Lake St, Crescent City, FL 32112. The listed phone number is (386) 698-2222.

What is Jesus Vazquez's specialty?

The primary specialty registered for this NPI is Dietetic Technician, Registered with taxonomy code 136A00000X.

When was this NPI record last updated?

The NPPES record for Jesus Vazquez was last updated on October 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.