Provider Demographics
NPI:1154484707
Name:VEGA, MARTA L (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTA
Middle Name:L
Last Name:VEGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 CALLE JOSE C VAZQUEZ
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-3325
Mailing Address - Country:US
Mailing Address - Phone:787-735-8001
Mailing Address - Fax:787-735-1525
Practice Address - Street 1:HOSPITAL GENERAL MENONITE
Practice Address - Street 2:CALLE JOSE VASQUEZ
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-735-8001
Practice Address - Fax:787-735-1525
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8511282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE43428Medicare UPIN
PR8662389652Medicare ID - Type Unspecified