Individual
BIANCA T VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1345 NE 4TH AVE, FORT LAUDERDALE, FL 33304-1031
(954) 458-1199
Mailing address
1608 TOWN CENTER BLVD STE A, WESTON, FL 33326-3639
(305) 218-6965
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104015
FL
Other
Enumeration date
01/26/2007
Last updated
05/03/2024
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