Provider Demographics
NPI:1649219791
Name:ROSARIO-VEGA, MARIA NELIDA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:NELIDA
Last Name:ROSARIO-VEGA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:N
Other - Last Name:ROSARIO-VEGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:6674 WEATHER VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-4019
Mailing Address - Country:US
Mailing Address - Phone:702-452-8028
Mailing Address - Fax:
Practice Address - Street 1:6674 WEATHER VIEW DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-4019
Practice Address - Country:US
Practice Address - Phone:702-452-8028
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist