Organization
DE LA VEGA MEDICAL GROUP CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE LIZ DE LA VEGA NP (ARNP-FNP)
(239) 848-9026
Entity
Organization
Contact information
Practice address
12781 WORLD PLAZA LN BLDG 88, FORT MYERS, FL 33907-7628
(239) 848-9026
Mailing address
225 SANTA BARBARA BLVD, CAPE CORAL, FL 33991-2032
(239) 848-9026
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
12/09/2022
Last updated
01/24/2024
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