Provider Demographics
NPI:1881324077
Name:VIGANO, DARA
Entity type:Individual
Prefix:
First Name:DARA
Middle Name:
Last Name:VIGANO
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 1:2605 W MOURA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-7178
Mailing Address - Country:US
Mailing Address - Phone:623-387-7940
Mailing Address - Fax:
Practice Address - Street 1:9842 W SANDS DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-3303
Practice Address - Country:US
Practice Address - Phone:623-243-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-12
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide