Healthcare Provider Details
I. General information
NPI: 1427122316
Provider Name (Legal Business Name): FRANCES COLON VEGA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/20/2006
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
RD. # 116 KM. 0.5
LAJAS PR
00667
US
IV. Provider business mailing address
PO BOX 538
LAJAS PR
00667-0538
US
V. Phone/Fax
- Phone: 939-214-7032
- Fax: 939-214-7032
- Phone: 939-214-7032
- Fax: 939-214-7032
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 4301073697 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 5714 |
| License Number State | PR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: