Provider Demographics
NPI:1821214255
Name:VARGAS FERNANDEZ, JUAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:E
Last Name:VARGAS FERNANDEZ
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:COND. VILLAS PARQUE DE ESCORIAL
Mailing Address - Street 2:EDIF. E APT. 1203
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-763-7521
Mailing Address - Fax:787-763-2480
Practice Address - Street 1:COND. VILLAS PARQUE DE ESCORIAL
Practice Address - Street 2:EDIF. E APT. 1203
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-763-7521
Practice Address - Fax:787-763-2480
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12712208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice