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Individual

ISAAC SAMUEL VERGARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
60 SW 17TH ST, OCALA, FL 34471-8142
(352) 482-0308
(524) 820-3113
Mailing address
PO BOX 3979, SARASOTA, FL 34230-3979
(352) 482-0308
(352) 482-0311

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME87592
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
71246S
MEDICARE PTAN
FL
01
7126T
MEDICARE PTAN
FL
Enumeration date
02/21/2006
Last updated
03/09/2021
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