MEDICARE: YULMARY VEGA M.D.

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	208D00000X	General Practice Physician	15086	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	400236	OTHER	PR	MEDICARE Y MUCHO MAS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22125	OTHER	PR	TRIPLE S
2	P00171352	OTHER	GA	PALMETTO
4	7770030	OTHER	PR	HUMANA HEALTH PLAN
5	P643	OTHER	PR	FIRST MEDICAL
6	201122	OTHER	PR	PREFERRED HEALTH
7	37641	OTHER	PR	PROSSAM
8	7770030	OTHER	PR	HUMANA INSURANCE
9	PG4633	OTHER	PR	PALIC PROVIDER

General Provider Information

NPI Number	:	1912948035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YULMARY VEGA M.D.

Provider Business Mailing Address
First Line	:	CALLE ZORZAL NUM 2
Second Line	:	URB VALLE SANTA BARBARA
City	:	GURABO
State	:	PR
Zip	:	00778-0000
Country	:	US
Telephone Number	:	787-734-4722
Fax Number	:

Provider Business Practice Location Address
First Line	:	CALLE ESCUTE NUM 27
Second Line	:
City	:	JUNCOS
State	:	PR
Zip	:	00777-0000
Country	:	US
Telephone Number	:	787-734-4722
Fax Number	:	787-734-4722

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	10/10/2012

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