Provider Demographics
NPI:1356742977
Name:VEGA, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:VEGA
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 1:14750 SW 26TH ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5933
Mailing Address - Country:US
Mailing Address - Phone:305-364-5533
Mailing Address - Fax:786-332-2919
Practice Address - Street 1:14750 SW 26TH ST
Practice Address - Street 2:SUITE 209
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5933
Practice Address - Country:US
Practice Address - Phone:305-364-5533
Practice Address - Fax:786-332-2919
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ6839235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist