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General NPI Number Information
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NPI Number | 1063248391
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Entity Type | Organization
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Legal Business Name | DR LUISA VEGA DNP LLC
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 525 TECHNOLOGY PARK STE 109
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City | LAKE MARY
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State | FL
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Zip | 32746-7107
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Country | US
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Telephone | 407-647-2346
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 117746
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City | ATLANTA
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State | GA
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Zip | 30368-7746
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Country | US
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Telephone | 407-647-2346
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Fax | 407-647-5431
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Authorized Official
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Title or Position | OWNER
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Name | LUISA SOLER VEGA
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Credential | DNP
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Telephone | 407-647-2346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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