Healthcare Provider Details

I. General information

NPI: 1972182004
Provider Name (Legal Business Name): LUISA MARIA VEGA PARRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 NW 155TH ST STE 202
MIAMI LAKES FL
33016-5865
US

IV. Provider business mailing address

7383 SW 22ND ST
MIAMI FL
33155-1426
US

V. Phone/Fax

Practice location:
  • Phone: 786-458-6042
  • Fax:
Mailing address:
  • Phone: 789-458-6042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number20-116932
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: