Provider Demographics
NPI:1396776175
Name:VARGAS, AGUSTIN ALBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:AGUSTIN
Middle Name:ALBERTO
Last Name:VARGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:600 UNIVERSITY BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2778
Mailing Address - Country:US
Mailing Address - Phone:561-627-2219
Mailing Address - Fax:561-627-5850
Practice Address - Street 1:600 UNIVERSITY BLVD.
Practice Address - Street 2:SUITE-200
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-0000
Practice Address - Country:US
Practice Address - Phone:561-627-2601
Practice Address - Fax:561-627-5850
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME23929207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL50632VMedicare PIN
D85875Medicare UPIN