Provider Demographics
NPI:1356039341
Name:COLON-VILLEGAS, SONYALI
Entity type:Individual
Prefix:
First Name:SONYALI
Middle Name:
Last Name:COLON-VILLEGAS
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 1:698 FLOYD ST SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-8629
Mailing Address - Country:US
Mailing Address - Phone:561-223-0116
Mailing Address - Fax:
Practice Address - Street 1:501 E KENNEDY BLVD STE 1400
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-5246
Practice Address - Country:US
Practice Address - Phone:813-638-0859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-269082106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician