Healthcare Provider Details

I. General information

NPI: 1699552414
Provider Name (Legal Business Name): MONICA BORGES VEGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2023
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 W FLAGLER ST STE 215
CORAL GABLES FL
33134-1402
US

IV. Provider business mailing address

16571 BLATT BLVD APT 202
WESTON FL
33326-1832
US

V. Phone/Fax

Practice location:
  • Phone: 786-653-6842
  • Fax:
Mailing address:
  • Phone: 786-653-6842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-289663
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: