Provider Demographics
NPI:1619981461
Name:DE ARMAS, MAEDELY
Entity Type:Individual
Prefix:
First Name:MAEDELY
Middle Name:
Last Name:DE ARMAS
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 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:305-642-0590
Mailing Address - Fax:305-642-6326
Practice Address - Street 1:3233 PALM AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5427
Practice Address - Country:US
Practice Address - Phone:305-642-0590
Practice Address - Fax:305-642-6326
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4182133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist