Provider Demographics
NPI:1285480954
Name:DEL RISCO, SAHILY
Entity type:Individual
Prefix:
First Name:SAHILY
Middle Name:
Last Name:DEL RISCO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8855 NW 180TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-6504
Mailing Address - Country:US
Mailing Address - Phone:786-973-3210
Mailing Address - Fax:
Practice Address - Street 1:5979 NW 151ST ST STE 120
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2448
Practice Address - Country:US
Practice Address - Phone:786-536-4420
Practice Address - Fax:305-402-2910
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11033163363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health