Provider Demographics
NPI:1104050699
Name:VEGA, SOBEIDA (EMT)
Entity type:Individual
Prefix:MS
First Name:SOBEIDA
Middle Name:
Last Name:VEGA
Suffix:
Gender:F
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 289
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-0289
Mailing Address - Country:US
Mailing Address - Phone:787-201-8419
Mailing Address - Fax:
Practice Address - Street 1:BARRIADA CABAN CALLE QUINTERO GONZALEZ
Practice Address - Street 2:CARR 459 K 07
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-1340
Practice Address - Country:US
Practice Address - Phone:787-646-8541
Practice Address - Fax:787-882-6566
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1887146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic