Provider Demographics
NPI:1801861810
Name:VIGO PRIETO, JUAN A (MD)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:A
Last Name:VIGO PRIETO
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:SAN JORGE CHILDRENS HOSPITAL
Mailing Address - Street 2:OFIC 404, CALLE SAN JORGE
Mailing Address - City:SANTURCE
Mailing Address - State:PR
Mailing Address - Zip Code:00912
Mailing Address - Country:US
Mailing Address - Phone:787-728-8052
Mailing Address - Fax:787-268-3579
Practice Address - Street 1:SAN JORGE CHILDRENS HOSPITAL
Practice Address - Street 2:OFIC 404, CALLE SAN JORGE
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-728-8052
Practice Address - Fax:787-268-3579
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR10280207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery