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NPI Code Detail

MEDICARE: JULIE DIAGO

MEDICARE: JULIE DIAGO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013209097
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE DIAGO
Provider Business Mailing Address
First Line : 5850 ATLANTIC AVE STE 112
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33484-8427
Country : US
Telephone Number : 561-336-0358
Fax Number : 561-431-2269
Provider Business Practice Location Address
First Line : 5850 ATLANTIC AVE STE 112
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33484-8427
Country : US
Telephone Number : 561-336-0358
Fax Number : 561-431-2269
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2011
Last Update Date : 09/16/2021

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Directions to “ JULIE DIAGO ” Practice Location

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