Provider Demographics
NPI:1275616765
Name:VICENTY, SONIA I (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:I
Last Name:VICENTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1511 LOS MIRADEROS CT
Mailing Address - Street 2:LOS GONZALES STREET
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-8813
Mailing Address - Country:US
Mailing Address - Phone:787-930-9078
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE CASIA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3200
Practice Address - Country:US
Practice Address - Phone:787-930-9078
Practice Address - Fax:787-641-9392
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13697207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease