Provider Demographics
NPI:1932113081
Name:VANEGAS, LUISA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUISA
Middle Name:
Last Name:VANEGAS
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 1:11399 LAKE UNDERHILL RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5023
Mailing Address - Country:US
Mailing Address - Phone:407-207-6768
Mailing Address - Fax:407-249-5025
Practice Address - Street 1:11399 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-5023
Practice Address - Country:US
Practice Address - Phone:407-207-6768
Practice Address - Fax:407-249-5025
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96309207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology