Provider Demographics
NPI:1295951325
Name:VARGAS, JOSE (JOSE VARGAS)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:
Last Name:VARGAS
Suffix:
Gender:M
Credentials:JOSE VARGAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6703 SW 92ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2444
Mailing Address - Country:US
Mailing Address - Phone:305-338-5918
Mailing Address - Fax:
Practice Address - Street 1:11865-A SW 26ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:305-227-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist