Individual provider · Type 1 NPI

Justina Li Vega, PA-C

Surgical Physician Assistant · Gainesville, GA

NPI number 1003558024 Active

Practice location

743 Spring St NE
Gainesville, GA 30501-3715

Call (770) 533-7288 Map

Fax (770) 534-9800

Mailing address

748 Old Norcross Rd Ste 100
Lawrenceville, GA 30046-3394

Other practice locations

  • 748 Old Norcross Rd Ste 100, Lawrenceville, GA 30046-3394 · (770) 339-1500
  • 1400 River Place, Braselton, GA 30517-5600 · (770) 533-7288

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X11301 (GA)
Physician Assistant 363A00000X11301 (GA)
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Surgical Physician Assistant Primary 363AS0400X11301 (GA)

Surgical Physician Assistant: Definition to come...

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About NPI 1003558024

Justina Li Vega, PA-C's National Provider Identifier is 1003558024, issued on Apr 11, 2022. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Gainesville, GA. The record was last updated on Jan 6, 2026.