Provider Demographics
NPI:1437509718
Name:VEGA, SONIA
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:VEGA
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 1:7741 NW 7TH ST APT 401
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-6115
Mailing Address - Country:US
Mailing Address - Phone:786-326-0705
Mailing Address - Fax:
Practice Address - Street 1:14100 NW 77TH CT STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1557
Practice Address - Country:US
Practice Address - Phone:786-502-3486
Practice Address - Fax:786-310-7094
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-16
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician