Provider Demographics
NPI:1184985376
Name:COLON-VEGA, MARIBEL (MD)
Entity type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:COLON-VEGA
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:HC 2 BOX 5876
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-8722
Mailing Address - Country:US
Mailing Address - Phone:787-862-3035
Mailing Address - Fax:
Practice Address - Street 1:HC 2 BOX 5876
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687-8722
Practice Address - Country:US
Practice Address - Phone:787-238-9679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18469207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine