Doctor Name: | DR. VICTOR MANUEL VARGAS |
NPI Number: | 1104988625 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 134421 |
Business Practice Address: | 699 W Cocoa Beach Cswy Suite 506 Cocoa Beach, FL - 329313577 |
Business Phone Number: | 3218682790 |
Business Fax Number: | 3218687221 |
Mailing Address: | Po Box 561600, ROCKLEDGE |
State: | FL |
Postal Code: | 329561600 |
Phone Number: | 3214344600 |
Fax Number: | 3214344662 |
NPI Enumeration Date: | 12/14/2006 |
NPI Last Update Date: | 05/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 134421 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |