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General NPI Number Information
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NPI Number | 1750776811
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Entity Type | Organization
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Legal Business Name | DACRIS HEALTH PRACTITIONERS, INC
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Dates
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Enumeration Date | 04/05/2015
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Last Update Date | 02/25/2016
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Provider Practice Location Address
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Address Line | 4880 NW 108TH PL
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City | DORAL
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State | FL
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Zip | 33178-4335
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Country | US
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Telephone | 786-312-0407
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Fax |
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Provider Business Mailing Address
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Address Line | 4880 NW 108TH PL
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City | DORAL
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State | FL
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Zip | 33178-4335
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Country | US
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Telephone | 786-312-0407
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUDIVINA VIGIL
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Credential | ARNP
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Telephone | 786-312-0407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP 9229298
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License Number State | FL
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