Individual
ANDY VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1724 GARDEN SAGE DR, OVIEDO, FL 32765-4617
(321) 544-3328
Mailing address
1724 GARDEN SAGE DR, OVIEDO, FL 32765-4617
(321) 544-3328
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-01-0532
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-01-0532
BCBA
FL
Enumeration date
11/02/2012
Last updated
11/07/2017
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