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Organization
VITA MAGIC LLC
Active
Organization
VITA MAGIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAMILET GONZALEZ LASTRE (PRESIDENT)
(786) 294-3483
Entity
Organization
Contact information
Practice address
7400 SW 139TH TER, PALMETTO BAY, FL 33158-1228
(786) 294-3483
Mailing address
7400 SW 139TH TER, PALMETTO BAY, FL 33158-1228
(786) 294-3483
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/10/2022
Last updated
11/10/2022
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