Healthcare Provider Details

I. General information

NPI: 1851219265
Provider Name (Legal Business Name): THALIA VEGA MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HCIENDAS DE SAN JOSE CALLE CENTRAL #9
PONCE PR
00731-9610
US

IV. Provider business mailing address

HC 6 BOX 2071
PONCE PR
00731-9610
US

V. Phone/Fax

Practice location:
  • Phone: 787-974-7022
  • Fax:
Mailing address:
  • Phone: 787-974-7022
  • Fax:

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: DR. THALIA CRISTAL VEGA CARATTINI
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 787-974-7022