Healthcare Provider Details

I. General information

NPI: 1376406306
Provider Name (Legal Business Name): YULMARY VEGA MEDICAL OFFICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 CALLE MUNOZ RIVERA
JUNCOS PR
00777-3338
US

IV. Provider business mailing address

PO BOX 628
HATILLO PR
00659-0628
US

V. Phone/Fax

Practice location:
  • Phone: 787-955-9850
  • Fax: 787-734-4722
Mailing address:
  • Phone: 787-955-9850
  • Fax: 787-734-4722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: YULMARY D VEGA
Title or Position: OWNER
Credential: MD
Phone: 787-955-9850