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General NPI Number Information
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NPI Number | 1386714251
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Entity Type | Individual
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Provider Name | RICARDO VEGA M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | CIM II CARR 165 #90 SUITE 303
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City | GUAYNABO
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State | PR
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Zip | 00968
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Country | US
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Telephone | 787-277-1166
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Fax | 787-277-1166
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Provider Business Mailing Address
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Address Line | 3011 PLAZA PLAYERA CAMINO DEL MAR
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City | TOA BAJA
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State | PR
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Zip | 00949-4368
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Country | US
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Telephone | 787-261-5034
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Fax | 787-795-1905
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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 | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 8807
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License Number State | PR
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