Organization
SOUTH COAST PHYSICAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL VARGAS MD (PRESIDENT)
(631) 979-8508
Entity
Organization
Contact information
Practice address
1799 BRENTWOOD RD, BRENTWOOD, NY 11717-4611
(631) 979-8508
(631) 979-0998
Mailing address
1 EDGEWOOD AVE, SUITE 100, SMITHTOWN, NY 11787-2742
(631) 979-8508
(631) 979-0998
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
213808-1
NY
Other
Enumeration date
11/17/2011
Last updated
11/18/2011
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