Basic Information
| Provider Information | |||||||||
| NPI: | 1134225477 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ANDRES VEGA MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 17347 | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333187347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543701053 | ||||||||
| FaxNumber: | 9543701533 | ||||||||
| Practice Location | |||||||||
| Address1: | 7100 W 20TH AVE | ||||||||
| Address2: | SUITE 601 | ||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330161897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543701053 | ||||||||
| FaxNumber: | 9543701533 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 10/31/2012 | ||||||||
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| AuthorizedOfficialLastName: | VEGA | ||||||||
| AuthorizedOfficialFirstName: | ANDRES | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3053641123 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | ME41377 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.