Most Relevant Information
Provider Data
| NPI Number: | 1003558024 |
| Provider Name: | JUSTINA LI VEGA PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 11301 |
Most Important Dates
| Enumeration Date: | 04/11/2022 |
| Last Updated: | 11/20/2023 |
Provider Practice Location
655 JESSE JEWELL PKWY SE
GAINESVILLE
GA
305013854
Practice Location Phone/Fax
| Phone: | 7705337288 |
| Fax: | 7705349800 |
Provider Mailing Location
748 OLD NORCROSS RD STE 100
LAWRENCEVILLE
GA
300463394
Provider Mailing Phone/Fax
| Phone: | 7703391500 |
| Fax: | 7703393528 |