Provider Demographics
NPI:1669229043
Name:VEGA MIRANDA, HAYDEE MARIA
Entity type:Individual
Prefix:
First Name:HAYDEE
Middle Name:MARIA
Last Name:VEGA MIRANDA
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 1:19164 NW 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-7404
Mailing Address - Country:US
Mailing Address - Phone:786-659-5841
Mailing Address - Fax:
Practice Address - Street 1:19164 NW 33RD AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-7404
Practice Address - Country:US
Practice Address - Phone:786-659-5841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9658363163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse