Provider Demographics
NPI:1306942594
Name:RAMSES VEGA MD PA
Entity type:Organization
Organization Name:RAMSES VEGA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMSES
Authorized Official - Middle Name:
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-554-6565
Mailing Address - Street 1:3720 SW 107TH AVE
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3639
Mailing Address - Country:US
Mailing Address - Phone:305-554-6565
Mailing Address - Fax:305-553-5271
Practice Address - Street 1:3720 SW 107TH AVE
Practice Address - Street 2:SUITE ONE
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3639
Practice Address - Country:US
Practice Address - Phone:305-554-6565
Practice Address - Fax:305-553-5271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73762207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257955300Medicaid
FL257955300Medicaid
FLK1404Medicare ID - Type Unspecified