Provider Demographics
NPI:1427247014
Name:MARIA T VARGAS MD
Entity type:Organization
Organization Name:MARIA T VARGAS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-434-2882
Mailing Address - Street 1:201 8TH ST S STE 303
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6117
Mailing Address - Country:US
Mailing Address - Phone:239-434-2882
Mailing Address - Fax:239-434-7639
Practice Address - Street 1:201 8TH ST S STE 303
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6117
Practice Address - Country:US
Practice Address - Phone:239-434-2882
Practice Address - Fax:239-434-7639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79687261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263745600Medicaid
FL12002OtherBCBS
FLF68560Medicare UPIN
FLK5450Medicare PIN