Provider Demographics
NPI:1417640871
Name:VERGEL EXPOSITO, AMMI ELIM
Entity Type:Individual
Prefix:
First Name:AMMI
Middle Name:ELIM
Last Name:VERGEL EXPOSITO
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 1:3963 26TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34117-8869
Mailing Address - Country:US
Mailing Address - Phone:239-601-8921
Mailing Address - Fax:
Practice Address - Street 1:3963 26TH AVE SE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34117-8869
Practice Address - Country:US
Practice Address - Phone:239-601-8921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst