Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 15750 | PR |
NPI | 1003835638 |
---|---|
Provider Name | Dr. Vanessa Vega Hernandez |
First Address | Trujillo Alto, PR 00976-3909 |
Second Address | Trujillo Alto, PR 00976 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 07/11/2018 |