# VAG SPECIALIST LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265100069
- **Authorized official:** MARIA NIETO MD (MANAGING MEMBER)
- **Authorized official phone:** (412) 398-5059

## Contact information

- **Practice address:** 401 SE OSCEOLA ST STE 200A, STUART, FL 34994-2503
- **Practice address phone:** (561) 318-0252
- **Practice address fax:** (561) 744-0735
- **Mailing address:** 401 SE OSCEOLA ST STE 200A, STUART, FL 34994-2503
- **Mailing address phone:** (561) 318-0252
- **Mailing address fax:** (561) 744-0735

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 207VF0040X | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician | — | NULL | — |
| 207VF0040X | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician | — | — | — |

## Other

- **Enumeration date:** 09/06/2021
- **Last updated:** 09/06/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 017290600 | — | FL |