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General NPI Number Information
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NPI Number | 1871569673
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Entity Type | Individual
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Provider Name | JESSICA RODRIGUEZ VEGA MD
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Gender | Female
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | CARR 123 KM 10.6 BO MAGUEYES LOCAL 6
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City | PONCE
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State | PR
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Zip | 00728
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Country | US
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Telephone | 787-284-3400
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Fax | 787-841-4092
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Provider Business Mailing Address
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Address Line | PO BOX 800652
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City | COTO LAUREL
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State | PR
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Zip | 00780-0652
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Country | US
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Telephone |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 13926
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License Number State | PR
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