Provider Demographics
NPI:1770910937
Name:VEGA, GLYNNIS LAYNET (MS, CFY-SLP)
Entity type:Individual
Prefix:
First Name:GLYNNIS
Middle Name:LAYNET
Last Name:VEGA
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15192 SW 13TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-2570
Mailing Address - Country:US
Mailing Address - Phone:786-942-5331
Mailing Address - Fax:
Practice Address - Street 1:950 PENINSULA CORPORATE CIR STE 1014
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1385
Practice Address - Country:US
Practice Address - Phone:561-994-6590
Practice Address - Fax:561-994-6690
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ6443235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist