Organization
VAG SPECIALIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA NIETO MD (MANAGING MEMBER)
(412) 398-5059
Entity
Organization
Contact information
Practice address
401 SE OSCEOLA ST STE 200A, STUART, FL 34994-2503
(561) 318-0252
(561) 744-0735
Mailing address
401 SE OSCEOLA ST STE 200A, STUART, FL 34994-2503
(561) 318-0252
(561) 744-0735
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017290600
—
FL
Enumeration date
09/06/2021
Last updated
09/06/2021
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