Provider Demographics
NPI:1205265543
Name:VARGAS, ANITA (MSW)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 E HORATIO AVE STE. 200
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751
Mailing Address - Country:US
Mailing Address - Phone:407-401-9020
Mailing Address - Fax:407-233-1337
Practice Address - Street 1:540 E HORATIO AVE STE. 200
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751
Practice Address - Country:US
Practice Address - Phone:407-401-9020
Practice Address - Fax:407-233-1337
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05449400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker