Provider Demographics
NPI:1609381466
Name:FARRAT DIAZ DE VILLEGAS, DARIA
Entity Type:Individual
Prefix:
First Name:DARIA
Middle Name:
Last Name:FARRAT DIAZ DE VILLEGAS
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 1:960 NW 78TH AVE UNIT 6
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-7805
Mailing Address - Country:US
Mailing Address - Phone:305-824-0230
Mailing Address - Fax:305-907-5322
Practice Address - Street 1:7789 NW 146TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1567
Practice Address - Country:US
Practice Address - Phone:305-824-0230
Practice Address - Fax:305-824-0230
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-02
Last Update Date:2017-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty