MEDICARE: LUIS E VEGA TORRES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1306672688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS E VEGA TORRES

Provider Business Mailing Address
First Line	:	9923 SW 147TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-1634
Country	:	US
Telephone Number	:	786-205-4515
Fax Number	:

Provider Business Practice Location Address
First Line	:	10300 SW 72ND ST STE 387
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3020
Country	:	US
Telephone Number	:	786-205-4515
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2024
Last Update Date	:	09/12/2024

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Directions to “ LUIS E VEGA TORRES ” Practice Location

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