Provider Demographics
NPI:1417639956
Name:VEGA LEBRON, PAOLA ENID
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:ENID
Last Name:VEGA LEBRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 BO CALZADA
Mailing Address - Street 2:
Mailing Address - City:MAUNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00707-2710
Mailing Address - Country:US
Mailing Address - Phone:939-248-6717
Mailing Address - Fax:
Practice Address - Street 1:151 CALLE TANCA UNIVERSIDAD ALBIZU
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901
Practice Address - Country:US
Practice Address - Phone:787-725-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program