Active NPI
Damaris Vega
- Clinical Social Worker
- Kissimmee, FL
National Provider Identifier
1770733131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17099
- Practice address
- 120 Broadway Ste 2043145
Kissimmee, FL 34741-5703 - Phone
- (321) 321-2066
- Fax
- (866) 901-7201
- NPI assigned
- Sep 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 17099 | FL | Primary |
Addresses
Primary practice location
120 Broadway Ste 2043145
Kissimmee, FL 34741-5703
Mailing address
3145 Via Otero Dr
Kissimmee, FL 34744-4103
Phone (413) 351-6470
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17099 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592265600000",
"number": "1770733131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3145 VIA OTERO DR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347444103",
"telephone_number": "413-351-6470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 BROADWAY STE 2043145",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347415703",
"telephone_number": "321-321-2066",
"fax_number": "866-901-7201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEGA",
"first_name": "DAMARIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-23",
"last_updated": "2020-06-16",
"certification_date": "2020-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "17099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.