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General NPI Number Information
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NPI Number | 1568030237
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Entity Type | Individual
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Provider Name | NORMA I ROMAN VEGA MED
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Gender | Female
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Dates
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Enumeration Date | 06/17/2021
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 6925 LAKE ELLENOR DR STE 120
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City | ORLANDO
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State | FL
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Zip | 32809-4648
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Country | US
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Telephone | 407-552-5444
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Fax |
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Provider Business Mailing Address
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Address Line | 3858 BAY CLUB CIR UNIT 104
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City | KISSIMMEE
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State | FL
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Zip | 34741-2631
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Country | US
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Telephone | 787-436-4669
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | FL
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