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General NPI Number Information
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NPI Number | 1295816775
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Entity Type | Individual
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Provider Name | RICHARD THOMAS VAGLEY MD
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Gender | Male
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 05/20/2020
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Provider Practice Location Address
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Address Line | SPECTRUM AESTHETICS 51 SW 42ND AVENUE
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City | CORAL GABLES
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State | FL
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Zip | 33134-1770
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Country | US
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Telephone | 305-514-0358
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Fax | 866-572-1427
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Provider Business Mailing Address
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Address Line | 343 MAJORCA AVENUE UNIT 202
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City | CORAL GABLES
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State | FL
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Zip | 33134-4325
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Country | US
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Telephone | 305-362-8678
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD011041E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | S4408
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME138014
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License Number State | FL
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