Healthcare Provider Details

I. General information

NPI: 1144839481
Provider Name (Legal Business Name): DUAIT VEGA MALAGON APRN-FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2020
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2656 SWOOPING SPARROW DR
HARMONY FL
34773-6188
US

IV. Provider business mailing address

2656 SWOOPING SPARROW DR
HARMONY FL
34773-6188
US

V. Phone/Fax

Practice location:
  • Phone: 786-412-2834
  • Fax:
Mailing address:
  • Phone: 786-412-2834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9564919
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number11042274
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: