Healthcare Provider Details

I. General information

NPI: 1750219366
Provider Name (Legal Business Name): IDALMI DARIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 W 38TH PL APT 108
HIALEAH FL
33012-4735
US

IV. Provider business mailing address

1475 W 38TH PL APT 108
HIALEAH FL
33012-4735
US

V. Phone/Fax

Practice location:
  • Phone: 786-817-1977
  • Fax:
Mailing address:
  • Phone: 786-817-1977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11026425
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: