Individual
JUSTINA LI VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 533-7288
(770) 534-9800
Mailing address
748 OLD NORCROSS RD STE 100, LAWRENCEVILLE, GA 30046-3394
(770) 339-1500
(770) 339-3528
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11301
GA
363AM0700X
Medical Physician Assistant
11301
GA
363AS0400X
Surgical Physician Assistant
Primary
11301
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2022
Last updated
01/06/2026
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