Provider Demographics
NPI:1275383226
Name:VOSS, SIBONEY MIRIEL CARMEN
Entity Type:Individual
Prefix:
First Name:SIBONEY
Middle Name:MIRIEL CARMEN
Last Name:VOSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 ROBERT J CONLAN BLVD NE APT 416
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-2765
Mailing Address - Country:US
Mailing Address - Phone:314-540-9644
Mailing Address - Fax:
Practice Address - Street 1:2175 ROBERT J CONLAN BLVD NE APT 416
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-2765
Practice Address - Country:US
Practice Address - Phone:314-540-9644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst