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Individual

MR. HERMAN SAMIR VERGARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.A.C.

Contact information

Practice address
3125 BRUTON BLVD, SUITE A, ORLANDO, FL 32805-6608
(407) 514-4470
(407) 514-4509
Mailing address
3125 BRUTON BLVD, SUITE A, ORLANDO, FL 32805-6608
(407) 514-4470
(407) 514-4509

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C.A.C. 4710
FL

Other

Enumeration date
11/08/2012
Last updated
11/08/2012
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