Provider Demographics
NPI:1164967170
Name:VEGA, NEISY L
Entity Type:Individual
Prefix:
First Name:NEISY
Middle Name:L
Last Name:VEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7267 W 24TH AVE APT 124
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6550
Mailing Address - Country:US
Mailing Address - Phone:786-312-0403
Mailing Address - Fax:
Practice Address - Street 1:7267 W 24TH AVE APT 124
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-6550
Practice Address - Country:US
Practice Address - Phone:786-312-0403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-29
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other