Provider Demographics
NPI:1316154958
Name:VIGAFRA PLLC
Entity type:Organization
Organization Name:VIGAFRA PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:YCAZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-803-8395
Mailing Address - Street 1:2001 MANATEE AVE E STE 103
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1620
Mailing Address - Country:US
Mailing Address - Phone:941-803-8395
Mailing Address - Fax:941-803-8158
Practice Address - Street 1:2105 MANATEE AVENUE EAST
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1620
Practice Address - Country:US
Practice Address - Phone:941-803-8395
Practice Address - Fax:941-803-8158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME66839OtherMEDICAL LICENSE
FLME66839OtherMEDICAL LICENSE