Provider Demographics
NPI:1043252760
Name:VIGO, JOSE J (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:J
Last Name:VIGO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:49 CALLE YAGUEZ
Mailing Address - Street 2:ESTANCIAS DEL RIO
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703-9628
Mailing Address - Country:US
Mailing Address - Phone:787-744-6071
Mailing Address - Fax:787-744-6071
Practice Address - Street 1:435 PONCE DE LEON AVE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3428
Practice Address - Country:US
Practice Address - Phone:787-754-0909
Practice Address - Fax:787-772-9710
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR52992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR00827835Medicare ID - Type UnspecifiedUPINC77469