Provider Demographics
NPI:1720658677
Name:DAEMA PINA PSYD LLC
Entity Type:Organization
Organization Name:DAEMA PINA PSYD LLC
Other - Org Name:VITA-COG COMMUNITH HEALTH, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINA DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:786-724-4224
Mailing Address - Street 1:3625 NW 82ND AVE STE 400D
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7602
Mailing Address - Country:US
Mailing Address - Phone:786-724-4224
Mailing Address - Fax:305-397-2285
Practice Address - Street 1:3625 NW 82ND AVE STE 400D
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-7602
Practice Address - Country:US
Practice Address - Phone:786-724-4224
Practice Address - Fax:305-397-2285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty