Provider Demographics
NPI:1528292307
Name:TOLEDO VEGA, MIGUEL A (BSPHARM, RPH, PHARMD)
Entity type:Individual
Prefix:
First Name:MIGUEL
Middle Name:A
Last Name:TOLEDO VEGA
Suffix:
Gender:M
Credentials:BSPHARM, RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 LA CANDELARIA ST
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-3874
Mailing Address - Country:US
Mailing Address - Phone:787-265-3330
Mailing Address - Fax:787-831-6716
Practice Address - Street 1:114 LA CANDELARIA ST
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-3874
Practice Address - Country:US
Practice Address - Phone:787-265-3330
Practice Address - Fax:787-831-6716
Is Sole Proprietor?:No
Enumeration Date:2009-05-08
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004676183500000X
FLPS42164183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist