Provider Demographics
NPI:1588011944
Name:DAHAN, YASMIRA
Entity Type:Individual
Prefix:
First Name:YASMIRA
Middle Name:
Last Name:DAHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 BRICKELL AVE
Mailing Address - Street 2:# 4210
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3930
Mailing Address - Country:US
Mailing Address - Phone:786-302-9764
Mailing Address - Fax:
Practice Address - Street 1:1330 CORAL WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2929
Practice Address - Country:US
Practice Address - Phone:786-452-7413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA67042225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist