Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | ME90218 | FL |
Y | 2081S0010X | Sports Medicine | ME90218 | FL |
Y | 213ES0000X | Sports Medicine | ME90218 | FL |
NPI | 1295874840 |
---|---|
Provider Name | Jose L Vargas |
First Address | The Woodlands, TX 77380-1480 |
Second Address | Miami, FL 33155-2800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 21/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
270437400 | (05) | FL |
50380 | BLUE CROSS & BLUE SHIELD (01) | FL |
I17403 | (02) | FL |