Basic Information
| Provider Information | |||||||||
| NPI: | 1154484707 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VEGA | ||||||||
| FirstName: | MARTA | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 121 CALLE JOSE C VAZQUEZ | ||||||||
| Address2: | |||||||||
| City: | AIBONITO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007053325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877358001 | ||||||||
| FaxNumber: | 7877351525 | ||||||||
| Practice Location | |||||||||
| Address1: | HOSPITAL GENERAL MENONITE | ||||||||
| Address2: | CALLE JOSE VASQUEZ | ||||||||
| City: | AIBONITO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877358001 | ||||||||
| FaxNumber: | 7877351525 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NR1301X | 8511 | PR | Y | Hospitals | General Acute Care Hospital | Rural |
No ID Information.