Healthcare Provider Details

I. General information

NPI: 1972218972
Provider Name (Legal Business Name): DAMARIS MEJIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2023
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7590 NW 186TH ST STE 209
HIALEAH FL
33015-2952
US

IV. Provider business mailing address

13253 NW 11TH TER
MIAMI FL
33182-2232
US

V. Phone/Fax

Practice location:
  • Phone: 786-953-6263
  • Fax: 786-953-6891
Mailing address:
  • Phone: 305-527-2815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11024028
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: