Provider Demographics
NPI:1336683853
Name:MACHADO VEGA, DAMARYS
Entity Type:Individual
Prefix:
First Name:DAMARYS
Middle Name:
Last Name:MACHADO VEGA
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 1:131 MENORES AVE APT 302
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4081
Mailing Address - Country:US
Mailing Address - Phone:786-991-8346
Mailing Address - Fax:
Practice Address - Street 1:131 MENORES AVE APT 302
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4081
Practice Address - Country:US
Practice Address - Phone:786-991-8346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst