Provider Demographics
NPI:1467187088
Name:VARGAS, ISABEL MARIE
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:MARIE
Last Name:VARGAS
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 1:3520 SPRINGVILLE DR
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-6360
Mailing Address - Country:US
Mailing Address - Phone:813-507-8674
Mailing Address - Fax:
Practice Address - Street 1:3520 SPRINGVILLE DR
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-6360
Practice Address - Country:US
Practice Address - Phone:813-507-8674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician