De La Vega, Mara
De La Vega, Mara is an individual health care provider with primary practice located at 1307 S. International Parkway Suite 2091, Lake Mary FL 32806-2916. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. De La Vega, Mara can be contacted via phone (407) 771-0404.Contact Information
Primary practice address
1307 S. International Parkway Suite 2091
Lake Mary FL 32806-2916
Phone: (407) 771-0404
Fax: (407) 771-0405
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME73219 | Florida |
Profile Details
| NPI number | 1750335147 |
|---|---|
| LBN Legal business name | De La Vega, Mara |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 20th, 2006 |
| Last updated | Dec 8th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750335147 | NPPES |
| Other | 080140852 | RAILROAD MEDICARE | |
| Other | 47060 | RAILROAD MEDICARE |
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