Provider Demographics
NPI:1801855523
Name:VARGAS-GONZALEZ, JOYCE LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:LYNN
Last Name:VARGAS-GONZALEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1217 CALLE DON QUIJOTE
Mailing Address - Street 2:COSTA CARIBE RESORT
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2020
Mailing Address - Country:US
Mailing Address - Phone:787-347-0618
Mailing Address - Fax:787-843-4362
Practice Address - Street 1:CARR 149 KM 63.8 GUAYABAL
Practice Address - Street 2:EDIFICIO CRUZ, SUITE 4
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-837-5577
Practice Address - Fax:787-843-4362
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR14411208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR14411OtherLICENCIA
PR14411OtherLICENCIA
PR2-3056Medicare ID - Type UnspecifiedMEDICARE PROVEEDOR