Provider Demographics
NPI:1982744397
Name:VARGAS, JANET (DRA)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:DRA
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 488
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676
Mailing Address - Country:US
Mailing Address - Phone:787-877-6684
Mailing Address - Fax:787-877-6684
Practice Address - Street 1:CALLE DON CHEMARY #32
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-877-6684
Practice Address - Fax:787-877-6684
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21131223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2379OtherFIST MEDICAL
PR670027OtherHUMANA OF PR
PR42163VAOtherSSS
PR237083OtherPREFERRED HEALTH CARE
986583OtherUNITED CONCORDIA