Dara Madelyn Vino, PA
Physician Assistant, Medical in Lake Mary, FL. Individual provider (NPI-1).
NPI number1023288917
StatusActive
Last updated in NPPESMar 27, 2023
Details
- NPI
- 1023288917
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Dara Madelyn Vino
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 6, 2008
- Certification date
- Mar 27, 2023
- Last updated
- Mar 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA9113919 | FL | Yes |
| 363A00000X | Physician Assistant | AMD-936 | HI | |
| 363AM0700X | Physician Assistant, Medical | PA-2744 | CO |
Practice location
156 N 4th StLake Mary, FL 32746-2963
Phone 407-644-2990 · Fax 407-644-4370
Mailing address
156 N 4th StLake Mary, FL 32746-2963
Phone 407-644-2990
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