Provider Demographics
NPI:1720251671
Name:VEGA, DANISHKA (RPH)
Entity type:Individual
Prefix:
First Name:DANISHKA
Middle Name:
Last Name:VEGA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 ORLANDO CENTRAL PKWY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-5600
Mailing Address - Country:US
Mailing Address - Phone:877-747-7259
Mailing Address - Fax:
Practice Address - Street 1:2424 ORLANDO CENTRAL PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5600
Practice Address - Country:US
Practice Address - Phone:877-747-7259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2016-09-25
Deactivation Date:2010-08-04
Deactivation Code:
Reactivation Date:2015-06-22
Provider Licenses
StateLicense IDTaxonomies
FLPS39996183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist