Provider Demographics
NPI:1255479762
Name:VARGAS, ADEL R (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEL
Middle Name:R
Last Name:VARGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-0759
Mailing Address - Country:US
Mailing Address - Phone:787-612-0813
Mailing Address - Fax:787-283-1159
Practice Address - Street 1:URB. MARIOLGA LUIS MUNOZ MARIN HOSP.HIMA
Practice Address - Street 2:SUITE 103
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726-4980
Practice Address - Country:US
Practice Address - Phone:787-612-0813
Practice Address - Fax:787-283-1159
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR104912080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR87723OtherSSS