Healthcare Provider Details

I. General information

NPI: 1063270783
Provider Name (Legal Business Name): DAYANA VILA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2024
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4005 NW 114TH AVE UNIT 22
DORAL FL
33178-4373
US

IV. Provider business mailing address

10118 SW 144TH AVE
MIAMI FL
33186-6994
US

V. Phone/Fax

Practice location:
  • Phone: 305-260-6913
  • Fax: 305-422-1805
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89573
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11031460
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: