Individual
JOSE LUIS VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 S DOUGLAS RD, CORAL GABLES, FL 33134-6914
(305) 445-8461
Mailing address
PO BOX 863481, ORLANDO, FL 32886-3481
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0060198
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055779000
—
FL
01
—
12454
BCBS
FL
01
—
P00356991
RR MCR
—
Enumeration date
03/29/2006
Last updated
12/17/2007
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