Healthcare Provider Details

I. General information

NPI: 1801756564
Provider Name (Legal Business Name): DAYANIS ELIZABETH CUZA RICARDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15924 SW 92ND AVE
PALMETTO BAY FL
33157-1842
US

IV. Provider business mailing address

10802 SW 228TH TER
MIAMI FL
33170-7509
US

V. Phone/Fax

Practice location:
  • Phone: 305-964-5824
  • Fax:
Mailing address:
  • Phone: 945-358-3142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: