Organization
DACRIS PRACTITIONER SERCICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LLUDIVINA VIGIL ANP-BC (PRESIDENT)
(305) 279-8187
Entity
Organization
Contact information
Practice address
10651 N KENDALL DR, STE 117, MIAMI, FL 33176-1569
(305) 279-8187
(305) 279-8194
Mailing address
10651 N KENDALL DR, STE 117, MIAMI, FL 33176-1569
(305) 279-8187
(305) 279-8194
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
Primary
9229298
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9229298
ANP LICENSE
FL
Enumeration date
07/14/2011
Last updated
07/14/2011
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