Healthcare Provider Details

I. General information

NPI: 1275166928
Provider Name (Legal Business Name): DAMARIS OCASIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22205 SW 100TH AVE
CUTLER BAY FL
33190-1545
US

IV. Provider business mailing address

22205 SW 100TH AVE
CUTLER BAY FL
33190-1545
US

V. Phone/Fax

Practice location:
  • Phone: 305-746-4939
  • Fax:
Mailing address:
  • Phone: 305-746-4939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9367704
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number11024358
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: