Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 6572 | PR |
NPI | 1083691430 |
---|---|
Provider Name | Dr. Miguel Angel Vega-Maldonado |
First Address | Cayey, PR 00737-2950 |
Second Address | Cayey, PR 00736-3818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
068240 | BLUE CROSS (01) | PR |
97934VE | TRIPLE S (01) | PR |
C78212 | (02) | PR |