Provider Demographics
NPI:1366820268
Name:VEGA, ROBERTO JOSE (DVM)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:JOSE
Last Name:VEGA
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 CALLE FLAMBOYAN
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00915-3444
Mailing Address - Country:US
Mailing Address - Phone:939-339-0554
Mailing Address - Fax:
Practice Address - Street 1:2009 CALLE FLAMBOYAN
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00915-3444
Practice Address - Country:US
Practice Address - Phone:939-339-0554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR374174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian