Provider Demographics
NPI:1275008849
Name:VEGA, ARTURO S (LMT 42267)
Entity Type:Individual
Prefix:MR
First Name:ARTURO
Middle Name:S
Last Name:VEGA
Suffix:
Gender:M
Credentials:LMT 42267
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5687 PARK RD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-6578
Mailing Address - Country:US
Mailing Address - Phone:786-877-5765
Mailing Address - Fax:
Practice Address - Street 1:2750 N 29TH AVE STE 312
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-1519
Practice Address - Country:US
Practice Address - Phone:786-877-5765
Practice Address - Fax:954-613-4126
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA42267225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist