MEDICARE: MARA DE LA VEGA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME73219	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080140852	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	47060	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750335147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARA DE LA VEGA MD

Provider Business Mailing Address
First Line	:	1307 S. INTERNATIONAL PARKWAY
Second Line	:	SUITE 2091
City	:	LAKE MARY
State	:	FL
Zip	:	32806-2916
Country	:	US
Telephone Number	:	407-771-0404
Fax Number	:	407-771-0405

Provider Business Practice Location Address
First Line	:	1307 S. INTERNATIONAL PARKWAY
Second Line	:	SUITE 2091
City	:	LAKE MARY
State	:	FL
Zip	:	32806-2916
Country	:	US
Telephone Number	:	407-771-0404
Fax Number	:	407-771-0405

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	12/08/2008

Similar Medicare Providers

1053319533 — DR. ROBERT COLLINS GREER IV D.O.
Practice Location Address:

624 US 1
LAKE PARK, FL
33403-2916

Practice Phone: 561-844-2464
Practice Fax: 561-844-1250

1073738464 — ARRANGING REALITY IN YOUR WORLD (ARW), INC.
Practice Location Address:

9020 LAKE FOREST BLVD
NEW ORLEANS, LA
70127-2916

Practice Phone: 504-975-3823
Practice Fax:

1528230026 — DR. DOUGLAS ARVOLD D.C
Practice Location Address:

1822 S MAIN ST
RICE LAKE, WI
54868-2916

Practice Phone: 715-234-3612
Practice Fax: 715-234-1904

1538393475 — OMEGA HEALTH CARE SERVICES INC
Practice Location Address:

1021 LAKE SHORE DR
BOWIE, MD
20721-2916

Practice Phone: 240-223-7389
Practice Fax:

1134483282 — DR. ROBERT COLLINS GREER V D.O.
Practice Location Address:

624 US 1
LAKE PARK, FL
33403-2916

Practice Phone: 561-844-2464
Practice Fax: 561-844-1250

1134506835 — MAY RICAFORT
Practice Location Address:

1737 NASHVILLE LN
CRYSTAL LAKE, IL
60014-2916

Practice Phone: 815-271-2845
Practice Fax:

Directions to “ MARA DE LA VEGA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.