Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 2946 | PR |
NPI | 1285759027 |
---|---|
Provider Name | Dr. Mercedes Vega Vidal |
First Address | San Juan, PR 00936-3102 |
Second Address | San Juan, PR 00918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |