Provider Demographics
NPI:1245127562
Name:VARGAS GONZALEZ, TOMAS Y
Entity type:Individual
Prefix:
First Name:TOMAS
Middle Name:Y
Last Name:VARGAS GONZALEZ
Suffix:
Gender:M
Credentials:
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 143322
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-3322
Mailing Address - Country:US
Mailing Address - Phone:787-669-7658
Mailing Address - Fax:
Practice Address - Street 1:3 CALLE PROGRESO
Practice Address - Street 2:OFICINA 203
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-5020
Practice Address - Country:US
Practice Address - Phone:939-219-7932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8602103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2603051OtherDRIVERS LICENSE