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General NPI Number Information
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NPI Number | 1992042493
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Entity Type | Individual
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Provider Name | MEYLIN C VEGA PA
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Gender | Female
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 1285 36TH ST SUITE 100
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City | VERO BEACH
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State | FL
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Zip | 32960-4885
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Country | US
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Telephone | 772-778-2009
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Fax |
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Provider Business Mailing Address
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Address Line | 3319 S STATE ROAD 7 STE 313
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City | WELLINGTON
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State | FL
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Zip | 33449-8147
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Country | US
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Telephone | 772-778-2009
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PAT9107027
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License Number State | FL
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