Provider Demographics
NPI:1578459517
Name:HERNANDEZ VEGA, YULIET (N/A)
Entity type:Individual
Prefix:MS
First Name:YULIET
Middle Name:
Last Name:HERNANDEZ VEGA
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:947 NE PINE ISLAND LN
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-2633
Mailing Address - Country:US
Mailing Address - Phone:239-565-7410
Mailing Address - Fax:
Practice Address - Street 1:947 NE PINE ISLAND LN
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-2633
Practice Address - Country:US
Practice Address - Phone:239-565-7410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-406573106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician