Provider Demographics
NPI:1649965054
Name:VEGA PEREZ, CARLOS ABNER
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:ABNER
Last Name:VEGA PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BO RIO HONDO 24
Mailing Address - Street 2:CALLE VILLA CRISTINA
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-349-4371
Mailing Address - Fax:
Practice Address - Street 1:BO RIO HONDO 24
Practice Address - Street 2:CALLE VILLA CRISTINA
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-349-4371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR923111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty