Justina Li Vega, PA-C
Physician Assistant, Surgical in Gainesville, GA. Individual provider (NPI-1).
NPI number1003558024
StatusActive
Last updated in NPPESJan 6, 2026
Details
- NPI
- 1003558024
- Entity type
- Individual (NPI-1)
- Name
- Justina Li Vega
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 11, 2022
- Certification date
- Jan 6, 2026
- Last updated
- Jan 6, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | 11301 | GA | Yes |
| 363AM0700X | Physician Assistant, Medical | 11301 | GA | |
| 363A00000X | Physician Assistant | 11301 | GA | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
743 Spring St NeGainesville, GA 30501-3715
Phone 770-533-7288 · Fax 770-534-9800
Mailing address
748 Old Norcross Rd Ste 100Lawrenceville, GA 30046-3394
Phone 770-339-1500 · Fax 770-339-3528
Other practice locations
1400 River Place
Braselton, GA 30517-5600
Braselton, GA 30517-5600
Phone 770-533-7288 · Fax 770-533-6511
748 Old Norcross Rd Ste 100
Lawrenceville, GA 30046-3394
Lawrenceville, GA 30046-3394
Phone 770-339-1500 · Fax 770-339-3528
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All 56 Surgical Physician Assistant providers in Gainesville · All 3,664 providers in Gainesville
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