Provider Demographics
NPI:1780462242
Name:ARRIETA VARGAS, MONICA CECILIA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:CECILIA
Last Name:ARRIETA VARGAS
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 1:876 MCKENNY AVE
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-7321
Mailing Address - Country:US
Mailing Address - Phone:407-668-6650
Mailing Address - Fax:
Practice Address - Street 1:876 MCKENNY AVE
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-7321
Practice Address - Country:US
Practice Address - Phone:407-668-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22222033106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician