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General NPI Number Information
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NPI Number | 1154535243
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Entity Type | Organization
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Legal Business Name | VICTOR M VEGA
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CARR 385, KM. 0.5, BO. CUEVAS CDT DE PENUELAS
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City | PENUELAS
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State | PR
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Zip | 00624
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Country | US
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Telephone | 787-585-3324
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Fax | 787-259-3292
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Provider Business Mailing Address
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Address Line | 535 CALLE JUAN RODRIGUEZ
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City | PENUELAS
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State | PR
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Zip | 00624-1804
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Country | US
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Telephone | 787-585-3324
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Fax | 787-259-3292
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Authorized Official
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Title or Position | OWNER
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Name | VICTOR M VEGA
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Credential |
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Telephone | 787-585-3324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | P1772
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License Number State | PR
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