Provider Demographics
NPI:1992999320
Name:VEGA, NIVIA M (PHARMTEC)
Entity type:Individual
Prefix:MRS
First Name:NIVIA
Middle Name:M
Last Name:VEGA
Suffix:
Gender:F
Credentials:PHARMTEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-0011
Mailing Address - Country:US
Mailing Address - Phone:787-846-4412
Mailing Address - Fax:787-846-7410
Practice Address - Street 1:BZN 11
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-0011
Practice Address - Country:US
Practice Address - Phone:787-846-4412
Practice Address - Fax:787-846-7410
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6795183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician