Provider Demographics
NPI:1891439543
Name:VICTOR VEGA MORALES LLC
Entity Type:Organization
Organization Name:VICTOR VEGA MORALES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SECRETARY/VICEPRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:EMMANUEL
Authorized Official - Last Name:VEGA MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-362-1618
Mailing Address - Street 1:1 SECT EL ABANICO
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-3804
Mailing Address - Country:US
Mailing Address - Phone:787-362-1618
Mailing Address - Fax:
Practice Address - Street 1:2 SECT EL ABANICO
Practice Address - Street 2:
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-3804
Practice Address - Country:US
Practice Address - Phone:787-869-3387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-27
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental