Provider Demographics
NPI:1447822960
Name:VEGA AGUILAR, PEDRO YUNIER
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:YUNIER
Last Name:VEGA AGUILAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 SAN JUAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-1528
Mailing Address - Country:US
Mailing Address - Phone:773-231-4092
Mailing Address - Fax:
Practice Address - Street 1:731 SAN JUAN BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-1528
Practice Address - Country:US
Practice Address - Phone:773-231-4092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor