MEDICARE: DENNISE VEGA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst		FL

General Provider Information

NPI Number	:	1760310551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNISE VEGA

Provider Business Mailing Address
First Line	:	8358 HARDY BAY LOOP
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-2316
Country	:	US
Telephone Number	:	908-216-1963
Fax Number	:	908-216-1963

Provider Business Practice Location Address
First Line	:	8358 HARDY BAY LOOP
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-2316
Country	:	US
Telephone Number	:	908-216-1963
Fax Number	:	908-216-1963

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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Directions to “ DENNISE VEGA ” Practice Location

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