Provider Demographics
NPI:1326041500
Name:PRATS VEGA, MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:
Last Name:PRATS VEGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 336, 405 AVE. ESMERALDA
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4457
Mailing Address - Country:US
Mailing Address - Phone:787-272-0668
Mailing Address - Fax:787-708-2588
Practice Address - Street 1:6 CALLE CARAZO
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5639
Practice Address - Country:US
Practice Address - Phone:787-272-3182
Practice Address - Fax:787-708-2588
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10382174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF01063Medicare UPIN
PR82565Medicare ID - Type Unspecified