Provider Demographics
NPI:1841225968
Name:VEGA LAGARES, ALEXANDRA (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:VEGA LAGARES
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 1:186 CALLE REY FRANCISCO
Mailing Address - Street 2:MANSIONES EN PASEO DE REYES
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-4021
Mailing Address - Country:US
Mailing Address - Phone:787-648-6200
Mailing Address - Fax:787-840-0707
Practice Address - Street 1:186 CALLE REY FRANCISCO
Practice Address - Street 2:MANSIONES EN PASEO DE REYES
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-4021
Practice Address - Country:US
Practice Address - Phone:787-648-6200
Practice Address - Fax:787-840-0707
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR14735208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice