Provider Demographics
NPI:1710751144
Name:VEGA, NANCY NUR (PHARMD, CPH)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:NUR
Last Name:VEGA
Suffix:
Gender:F
Credentials:PHARMD, CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 W CORPORATE LAKES BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3663
Mailing Address - Country:US
Mailing Address - Phone:800-832-8585
Mailing Address - Fax:
Practice Address - Street 1:2955 W CORPORATE LAKES BLVD STE 600
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3663
Practice Address - Country:US
Practice Address - Phone:800-832-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36769183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist