Provider Demographics
NPI:1285756536
Name:VARGAS, ROBERTO L (MD)
Entity type:Individual
Prefix:
First Name:ROBERTO
Middle Name:L
Last Name:VARGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5677 HORSESHOE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14143-9513
Mailing Address - Country:US
Mailing Address - Phone:585-922-4260
Mailing Address - Fax:585-922-5427
Practice Address - Street 1:1425 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3001
Practice Address - Country:US
Practice Address - Phone:585-922-4260
Practice Address - Fax:585-922-5427
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY243676207ZC0006X, 207ZM0300X, 207ZP0007X, 207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology
No207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical Microbiology
No207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology