Provider Demographics
NPI:1003606633
Name:VARGAS RODRIGUEZ, NORANGELY
Entity type:Individual
Prefix:
First Name:NORANGELY
Middle Name:
Last Name:VARGAS RODRIGUEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 26 X 25 URB. JARDINES DEL CARIBE
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-4413
Mailing Address - Country:US
Mailing Address - Phone:939-245-4610
Mailing Address - Fax:
Practice Address - Street 1:2979 AVE EMILIO FAGOT
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-3617
Practice Address - Country:US
Practice Address - Phone:787-841-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16478183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician