Provider Demographics
NPI:1467227033
Name:VARGAS, LEA CRISTINA
Entity Type:Individual
Prefix:
First Name:LEA
Middle Name:CRISTINA
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 1:9334 SW 212TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3732
Mailing Address - Country:US
Mailing Address - Phone:305-910-4569
Mailing Address - Fax:
Practice Address - Street 1:9334 SW 212TH TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-3732
Practice Address - Country:US
Practice Address - Phone:305-910-4569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-23
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician