Provider Demographics
NPI:1619581428
Name:VEGA QUIROGA, BELKIS
Entity Type:Individual
Prefix:MRS
First Name:BELKIS
Middle Name:
Last Name:VEGA QUIROGA
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 1:9000 NW 15TH ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2990
Mailing Address - Country:US
Mailing Address - Phone:786-894-6358
Mailing Address - Fax:
Practice Address - Street 1:9980 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6139
Practice Address - Country:US
Practice Address - Phone:954-334-3151
Practice Address - Fax:954-675-5719
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008701363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner