Provider Demographics
NPI:1740391960
Name:CARMONA VARGAS, NESTOR ANDRES (MD)
Entity Type:Individual
Prefix:DR
First Name:NESTOR
Middle Name:ANDRES
Last Name:CARMONA VARGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1699
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-1699
Mailing Address - Country:US
Mailing Address - Phone:787-525-4825
Mailing Address - Fax:
Practice Address - Street 1:1845 CARR 2 STE 302
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7203
Practice Address - Country:US
Practice Address - Phone:787-780-4069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5491207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC84191Medicare UPIN