Provider Demographics
NPI:1851858021
Name:PORTO FAJARDO, DAYAMI (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:DAYAMI
Middle Name:
Last Name:PORTO FAJARDO
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 EAST DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6110
Mailing Address - Country:US
Mailing Address - Phone:786-251-8120
Mailing Address - Fax:
Practice Address - Street 1:3200 SW 60TH CT STE 302
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4071
Practice Address - Country:US
Practice Address - Phone:305-662-8330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9286427363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner