Healthcare Provider Details

I. General information

NPI: 1992773931
Provider Name (Legal Business Name): HIGINIO A. VEGA-OJEDA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 10/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR.111 KM. 1.8 CONSULTORIO MEDICINA DE FAMILIA
LARES PR
00669-0000
US

IV. Provider business mailing address

PO BOX 436
LARES PR
00669-0436
US

V. Phone/Fax

Practice location:
  • Phone: 787-897-5700
  • Fax: 787-897-5700
Mailing address:
  • Phone: 787-897-5700
  • Fax: 787-897-5700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7794
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: