Provider Demographics
NPI:1194384297
Name:JORGE A. VEGA JR., M.D., PLLC
Entity Type:Organization
Organization Name:JORGE A. VEGA JR., M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:561-440-3740
Mailing Address - Street 1:2800 E COMMERCIAL BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4202
Mailing Address - Country:US
Mailing Address - Phone:561-440-3740
Mailing Address - Fax:
Practice Address - Street 1:2800 E COMMERCIAL BLVD STE 102
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4202
Practice Address - Country:US
Practice Address - Phone:954-491-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty