Organization
D DE LA VEGA MD P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAGOBERTO DE LA VEGA MD (PRESIDENT)
(305) 298-9100
Entity
Organization
Contact information
Practice address
11093 NW 138TH ST UNIT 112, HIALEAH GARDENS, FL 33018-1190
(305) 552-0303
(305) 554-0709
Mailing address
11093 NW 138TH ST UNIT 112, HIALEAH GARDENS, FL 33018-1190
(305) 552-0303
(305) 554-0709
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME67856
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26980
BCBS PROVIDER#
FL
05
—
377494501
—
FL
Enumeration date
05/16/2006
Last updated
02/19/2020
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