Provider Demographics
NPI:1669517538
Name:VEGA-GINORIO, RAUL (MT)
Entity type:Individual
Prefix:
First Name:RAUL
Middle Name:
Last Name:VEGA-GINORIO
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:186 VIA MEDIALUNA
Mailing Address - Street 2:HACIENDA SAN JOSE
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-3017
Mailing Address - Country:US
Mailing Address - Phone:787-403-5676
Mailing Address - Fax:
Practice Address - Street 1:33 # 17 AVE ROBERTO CLEMENTE
Practice Address - Street 2:VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-769-8349
Practice Address - Fax:787-257-8490
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR6787246QH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QH0000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyHematology