Provider Demographics
NPI:1013190008
Name:VEGA RIOS, VIMARI (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:VIMARI
Middle Name:
Last Name:VEGA RIOS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AJ12 CALLE 26
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3424
Mailing Address - Country:US
Mailing Address - Phone:787-381-9116
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO CENTURION PISO 3 CARR. #2 KM 11.8
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-995-2700
Practice Address - Fax:787-995-2706
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist