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NPI Code Detail

MEDICARE: DR. JORGE LUIS VEGA MORALES PA

MEDICARE: DR. JORGE LUIS VEGA MORALES PA
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
1363AM0700XMedical Physician Assistant002256-PAPR

General Provider Information

NPI Number : 1891316105
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JORGE LUIS VEGA MORALES PA
Provider Business Mailing Address
First Line : 9495 SW 72ND ST STE B180
Second Line :
City : MIAMI
State : FL
Zip : 33173-5424
Country : US
Telephone Number : 305-274-5319
Fax Number : 305-274-5320
Provider Business Practice Location Address
First Line : 9495 SW 72ND ST STE B180
Second Line :
City : MIAMI
State : FL
Zip : 33173-5424
Country : US
Telephone Number : 305-274-5319
Fax Number : 305-274-5320
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2020
Last Update Date : 09/26/2024

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Directions to “ DR. JORGE LUIS VEGA MORALES PA” Practice Location

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