Provider Demographics
NPI:1891713202
Name:VERGARA, FELIX CARINO (MD)
Entity Type:Individual
Prefix:DR
First Name:FELIX
Middle Name:CARINO
Last Name:VERGARA
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 1:2601 ANNAND DR STE 14
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-3719
Mailing Address - Country:US
Mailing Address - Phone:302-633-9049
Mailing Address - Fax:888-868-7503
Practice Address - Street 1:2601 ANNAND DR STE 14
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-3719
Practice Address - Country:US
Practice Address - Phone:302-633-9049
Practice Address - Fax:888-868-7503
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0006319207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8551901Medicaid
NJH43226Medicare UPIN
NJ049550Medicare ID - Type UnspecifiedMEDICARE