Provider Demographics
NPI:1659362895
Name:VEGA, DESSIE L (MD)
Entity Type:Individual
Prefix:DR
First Name:DESSIE
Middle Name:L
Last Name:VEGA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 51911
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1911
Mailing Address - Country:US
Mailing Address - Phone:787-261-6199
Mailing Address - Fax:787-261-3552
Practice Address - Street 1:CALLE RUFINO MARTINEZ AX-1
Practice Address - Street 2:LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-261-6199
Practice Address - Fax:787-261-3552
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2022-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR103972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF96808Medicare UPIN