Provider Demographics
NPI:1235188905
Name:VEGA, HERMAN E (PHD, AP, LMHC)
Entity Type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:E
Last Name:VEGA
Suffix:
Gender:M
Credentials:PHD, AP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14411 COMMERCE WAY STE 316
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1532
Mailing Address - Country:US
Mailing Address - Phone:305-644-7294
Mailing Address - Fax:305-644-7295
Practice Address - Street 1:14411 COMMERCE WAY STE 315
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1532
Practice Address - Country:US
Practice Address - Phone:305-644-7294
Practice Address - Fax:305-644-7295
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 1008171100000X
FLMH2630101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171100000XOther Service ProvidersAcupuncturist