Individual
ALAN VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1008 MIMOSA ST, LAKE PLACID, FL 33852-8695
(863) 840-3612
Mailing address
1008 MIMOSA ST, LAKE PLACID, FL 33852-8695
(863) 840-3612
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA30759
FL
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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