Healthcare Provider Details

I. General information

NPI: 1497107767
Provider Name (Legal Business Name): DAIME SARMIENTO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 W 67TH ST
HIALEAH FL
33012-6464
US

IV. Provider business mailing address

811 W 67TH ST
HIALEAH FL
33012-6464
US

V. Phone/Fax

Practice location:
  • Phone: 306-764-7507
  • Fax:
Mailing address:
  • Phone: 306-764-7507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: