Provider Demographics
NPI:1871905786
Name:ESTEVEZ URRA, DAGMARIS
Entity type:Individual
Prefix:
First Name:DAGMARIS
Middle Name:
Last Name:ESTEVEZ URRA
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 1:10580 SW 62ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2819
Mailing Address - Country:US
Mailing Address - Phone:786-499-5934
Mailing Address - Fax:
Practice Address - Street 1:14736 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1481
Practice Address - Country:US
Practice Address - Phone:305-387-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAR.M.A 555014247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other