Doctor Name: | DR. JUAN G SANTIAGO VEGA |
NPI Number: | 1295960268 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | 17561 |
License Number: | 17561 |
Business Practice Address: | Hc03 Box 13437 Penuelas, PR - 00624 |
Business Phone Number: | 7878362216 |
Business Fax Number: | |
Mailing Address: | Hc03, Box13437 PENUELAS |
State: | PR |
Postal Code: | 00624 |
Phone Number: | 7878362216 |
Fax Number: | |
NPI Enumeration Date: | 05/20/2009 |
NPI Last Update Date: | 12/28/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 17561 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |