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General NPI Number Information
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NPI Number | 1376993436
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Entity Type | Individual
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Provider Name | ROSA M VEGA
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Gender | Female
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Dates
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Enumeration Date | 06/20/2016
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Last Update Date | 02/01/2020
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Provider Practice Location Address
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Address Line | 14973 SW 9TH TER
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City | MIAMI
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State | FL
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Zip | 33194-2940
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Country | US
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Telephone | 786-519-5765
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Fax |
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Provider Business Mailing Address
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Address Line | 110 FONTAINEBLEAU BLVD APT 404
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City | MIAMI
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State | FL
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Zip | 33172-4571
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-19-10230
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License Number State | FL
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