Provider Demographics
NPI:1801448113
Name:VIGO MEDICAL GROUP LLC
Entity type:Organization
Organization Name:VIGO MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VIGO PAREDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-826-0440
Mailing Address - Street 1:37 CALLE SAN ANTONIO
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-3092
Mailing Address - Country:US
Mailing Address - Phone:787-826-0440
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty