Healthcare Provider Details

I. General information

NPI: 1710818885
Provider Name (Legal Business Name): DAYANNY AGON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8410 SW 202ND ST
CUTLER BAY FL
33189-2036
US

IV. Provider business mailing address

6745 SW 132ND AVE APT 304
MIAMI FL
33183-2387
US

V. Phone/Fax

Practice location:
  • Phone: 305-300-6936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA32759
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: