Healthcare Provider Details

I. General information

NPI: 1194648121
Provider Name (Legal Business Name): VEGA MEDICAL SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 PONCE DE LEON BLVD STE 201&202
CORAL GABLES FL
33134-2060
US

IV. Provider business mailing address

717 PONCE DE LEON BLVD STE 201&202
CORAL GABLES FL
33134-2060
US

V. Phone/Fax

Practice location:
  • Phone: 786-301-6461
  • Fax:
Mailing address:
  • Phone: 786-301-6461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MARILIN VEGA FERRIOL
Title or Position: OWNER
Credential: CNA
Phone: 786-301-6461