Provider Demographics
NPI:1073599809
Name:VARGAS QUINONES, CESAR I (MD)
Entity Type:Individual
Prefix:
First Name:CESAR
Middle Name:I
Last Name:VARGAS QUINONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CESAR
Other - Middle Name:I
Other - Last Name:VARGAS QUINONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:18 URB RAHOLISA GDNS
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-2418
Mailing Address - Country:US
Mailing Address - Phone:787-280-9161
Mailing Address - Fax:
Practice Address - Street 1:1500 AVE EMERITO ESTRADA
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-3026
Practice Address - Country:US
Practice Address - Phone:787-280-9161
Practice Address - Fax:787-926-0047
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12045208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR060598OtherCRUZ AZUL DE PR
PR88564VAOtherTRIPLES SS S
PR32261OtherAMPR
PR0122254OtherACAA
PR9670176OtherCIGNA
PR6850036OtherHUMANA
PR060598OtherCRUZ AZUL DE PR
PR0088564Medicare ID - Type Unspecified
PR10022OWOtherMMM
PR88564VAOtherTRIPLES SS S
PR9670176OtherCIGNA