Individual
DAMARIS AGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
963 TOWN CENTER DR STE 100, ORANGE CITY, FL 32763-8254
(217) 238-3000
(217) 238-3008
Mailing address
15280 NW 79TH CT STE 200, MIAMI LAKES, FL 33016-5873
(305) 558-3724
(786) 907-4485
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085004462
IL
363A00000X
Physician Assistant
Primary
PA9110129
FL
Other
Enumeration date
10/11/2012
Last updated
12/16/2024
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