Provider Demographics
NPI:1629667571
Name:VEGA BELMONTE, AIMEE D
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:D
Last Name:VEGA BELMONTE
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 1:1217 CONSTANTINE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5303
Mailing Address - Country:US
Mailing Address - Phone:904-755-0283
Mailing Address - Fax:
Practice Address - Street 1:1217 CONSTANTINE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-5303
Practice Address - Country:US
Practice Address - Phone:904-755-0283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20-140657106S00000X
FL0-24-15012106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1629667571Medicaid