Provider Demographics
NPI:1144839481
Name:VEGA MALAGON, DUAIT
Entity type:Individual
Prefix:
First Name:DUAIT
Middle Name:
Last Name:VEGA MALAGON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W 56TH ST APT 1408
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-4770
Mailing Address - Country:US
Mailing Address - Phone:786-412-2834
Mailing Address - Fax:
Practice Address - Street 1:2422 NW 87TH PL
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1201
Practice Address - Country:US
Practice Address - Phone:786-412-2834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-22
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
FLRN9564919163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No251B00000XAgenciesCase Management