Provider Demographics
NPI:1346684586
Name:VEGAS, ANNE-MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:
Last Name:VEGAS
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4332 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3139
Mailing Address - Country:US
Mailing Address - Phone:941-277-8040
Mailing Address - Fax:941-277-8045
Practice Address - Street 1:4332 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3139
Practice Address - Country:US
Practice Address - Phone:941-277-8040
Practice Address - Fax:941-277-8045
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN3327363A00000X
DEC5-0000871363A00000X
FLPA9119668363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant