Provider Demographics
NPI:1598971020
Name:VEGA, ESTRELLA SURMIA (MD)
Entity Type:Individual
Prefix:
First Name:ESTRELLA
Middle Name:SURMIA
Last Name:VEGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ESTRELLA
Other - Middle Name:SURMIA
Other - Last Name:SOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:201 N PARK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4147
Mailing Address - Country:US
Mailing Address - Phone:407-814-2680
Mailing Address - Fax:407-814-2068
Practice Address - Street 1:201 N PARK AVE STE 201
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4147
Practice Address - Country:US
Practice Address - Phone:407-889-1953
Practice Address - Fax:407-889-1954
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103508207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine