Provider Demographics
NPI:1326356395
Name:VIGO VIGO, RONALD B (M D)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:B
Last Name:VIGO VIGO
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 997
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0997
Mailing Address - Country:US
Mailing Address - Phone:787-464-8337
Mailing Address - Fax:
Practice Address - Street 1:37 CALLE SAN ANTONIO
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-3092
Practice Address - Country:US
Practice Address - Phone:787-826-0440
Practice Address - Fax:787-658-6705
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR018637207RN0300X, 207RN0300X
FLME125712207RN0300X
PR12707-I208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice