Provider Demographics
NPI:1720875735
Name:IBRAGIMOVA, DAMIRA
Entity type:Individual
Prefix:
First Name:DAMIRA
Middle Name:
Last Name:IBRAGIMOVA
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 1:1922 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3723
Mailing Address - Country:US
Mailing Address - Phone:929-272-7232
Mailing Address - Fax:
Practice Address - Street 1:4770 BISCAYNE BLVD STE 750
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3242
Practice Address - Country:US
Practice Address - Phone:305-640-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9622855163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse