=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558254938
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DG MENTAL HEALTH PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2025
-----------------------------------------------------
Last Update Date | 06/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18901 SW 106TH AVE STE 138
-----------------------------------------------------
City | CUTLER BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-7663
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-903-2031
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18901 SW 106TH AVE STE 138
-----------------------------------------------------
City | CUTLER BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-7663
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-903-2031
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DARIEL ASGARALI
-----------------------------------------------------
Credential | APRN
-----------------------------------------------------
Telephone | 305-903-2031
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------