Provider Demographics
NPI:1801996624
Name:VIGO TOSADO, MIGUEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:A
Last Name:VIGO TOSADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1227
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1227
Mailing Address - Country:US
Mailing Address - Phone:787-834-6018
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL BELLA VISTA
Practice Address - Street 2:349 ST.
Practice Address - City:CERRO LAS MESAS
Practice Address - State:PR
Practice Address - Zip Code:00680-1227
Practice Address - Country:US
Practice Address - Phone:787-834-6018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6913207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD08449Medicare UPIN
PR28154Medicare ID - Type Unspecified