Provider Demographics
NPI:1811595176
Name:ACHILLE, VASTHI MARLEE
Entity Type:Individual
Prefix:
First Name:VASTHI
Middle Name:MARLEE
Last Name:ACHILLE
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 1:860 NW 168TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5327
Mailing Address - Country:US
Mailing Address - Phone:786-923-7016
Mailing Address - Fax:
Practice Address - Street 1:860 NW 168TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-5327
Practice Address - Country:US
Practice Address - Phone:786-923-7016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program