Provider Demographics
NPI:1821212259
Name:VARGAS, GLADYS (MD)
Entity Type:Individual
Prefix:DR
First Name:GLADYS
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
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 4707
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4707
Mailing Address - Country:US
Mailing Address - Phone:787-930-9984
Mailing Address - Fax:787-891-9146
Practice Address - Street 1:BO. BORINQUEN
Practice Address - Street 2:CARR 107 KM 1.1
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00605-4707
Practice Address - Country:US
Practice Address - Phone:787-930-9984
Practice Address - Fax:787-891-9146
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6953208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice