Provider Demographics
NPI:1316574304
Name:VEGA GONZALEZ, JENIFFER MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:JENIFFER
Middle Name:MARIE
Last Name:VEGA GONZALEZ
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 2101
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-9769
Mailing Address - Country:US
Mailing Address - Phone:787-237-5828
Mailing Address - Fax:
Practice Address - Street 1:CARR 315 BO SABANA YEGUAS
Practice Address - Street 2:CENTRO COMERCIAL MUNICIPAL DE LAJAS EDF 2 LOCAL 4
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667-2411
Practice Address - Country:US
Practice Address - Phone:787-237-5828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor