Provider Demographics
NPI:1255716494
Name:VILSAINT, NADEGE
Entity type:Individual
Prefix:
First Name:NADEGE
Middle Name:
Last Name:VILSAINT
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 1:12580 NE MIAMI CT
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4568
Mailing Address - Country:US
Mailing Address - Phone:305-308-5899
Mailing Address - Fax:
Practice Address - Street 1:1125 NE 125TH ST STE 225
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5034
Practice Address - Country:US
Practice Address - Phone:305-775-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL$$$$$$$$$OtherIRS