Basic Information
Provider Information
NPI: 1801050695
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VEGA-MARTINEZ
FirstName: JOSE
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: MEDICINA INTERNA RCM
Address2: PO BOX 29134
City: SAN JUAN
State: PR
PostalCode: 009290134
CountryCode: US
TelephoneNumber: 7877516034
FaxNumber: 7877541739
Practice Location
Address1: UNIVERSITY DISTRICT HOSPITAL
Address2: MEDICAL CENTER UDH 2 PO 2116
City: SAN JUAN
State: PR
PostalCode: 009222116
CountryCode: US
TelephoneNumber: 7877540101
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/11/2008
LastUpdateDate: 08/24/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X018171PRN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RG0100X018171PRY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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