MEDICARE: SUSET DIAZ MARTINEZ

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
1	2355S0801X	Speech-Language Assistant	SI8581	FL

General Provider Information

NPI Number	:	1063366953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSET DIAZ MARTINEZ

Provider Business Mailing Address
First Line	:	5125 PALM SPRINGS BLVD UNIT 3208
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-5015
Country	:	US
Telephone Number	:	727-226-0837
Fax Number	:

Provider Business Practice Location Address
First Line	:	5125 PALM SPRINGS BLVD UNIT 3208
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-5015
Country	:	US
Telephone Number	:	727-226-0837
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2026
Last Update Date	:	02/25/2026

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Directions to “ SUSET DIAZ MARTINEZ ” Practice Location

Language	Start Address	Practice Location

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