Provider Demographics
NPI:1245201946
Name:VEGLIO, LUIS E (PSY D)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:E
Last Name:VEGLIO
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1316
Mailing Address - Street 2:
Mailing Address - City:SAINT JUST
Mailing Address - State:PR
Mailing Address - Zip Code:00978-1316
Mailing Address - Country:US
Mailing Address - Phone:787-309-7064
Mailing Address - Fax:787-946-1416
Practice Address - Street 1:C9 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3330
Practice Address - Country:US
Practice Address - Phone:787-485-1583
Practice Address - Fax:787-946-1416
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR01615103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR549688OtherFHC HEALTH SERVICES
PRM000566OtherMENONITA HEALTH SERVICE
PR2968OtherHUMANA HEALTH PROVIDER