Provider Demographics
NPI:1710994447
Name:VEGA CARATTINI, GLORIA VE (MD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:VE
Last Name:VEGA CARATTINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GLORIA
Other - Middle Name:V
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:B5 CALLE SANTA CRUZ
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6902
Mailing Address - Country:US
Mailing Address - Phone:787-787-3422
Mailing Address - Fax:787-787-0750
Practice Address - Street 1:B5 CALLE SANTA CRUZ
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6902
Practice Address - Country:US
Practice Address - Phone:787-787-3422
Practice Address - Fax:787-787-0750
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2565207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE30413Medicare UPIN