Healthcare Provider Details

I. General information

NPI: 1124658695
Provider Name (Legal Business Name): DAILYN VEGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12963 W OKEECHOBEE RD UNIT 3
HIALEAH GARDENS FL
33018-6055
US

IV. Provider business mailing address

17884 SW 107TH AVE APT 21
MIAMI FL
33157-5182
US

V. Phone/Fax

Practice location:
  • Phone: 786-536-9329
  • Fax:
Mailing address:
  • Phone: 786-878-2099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberCBHCMS0102690
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: