MEDICARE: MS. CYNTHIA DIAZ SANCHEZ L.C.S.W.

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	1041C0700X	Clinical Social Worker	SW 2548	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FL 2256	OTHER	FL	UNIPSYCH
2	SANCCYNT	OTHER	FL	LIFESYNCH - CORPHEALTH (HUMANA)
3	11614783	OTHER	FL	CAQH
4	2165768	OTHER	FL	COMPSYCH
5	282088	OTHER	FL	VALUE OPTIONS PROVIDER ID
6	20919	OTHER	FL	CIGNA BEHAVIORAL HEALTH
7	501699693	OTHER	FL	UNITED BEHAVIORAL HEALTH
8	7244935	OTHER	FL	AETNA
9	Z4609	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1265457725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA DIAZ SANCHEZ L.C.S.W.

Provider Business Mailing Address
First Line	:	5121 EHRLICH RD
Second Line	:	SUITE 104-B
City	:	TAMPA
State	:	FL
Zip	:	33624-2049
Country	:	US
Telephone Number	:	813-968-8801
Fax Number	:	813-960-9373

Provider Business Practice Location Address
First Line	:	5121 EHRLICH RD
Second Line	:	SUITE 104-B
City	:	TAMPA
State	:	FL
Zip	:	33624-2049
Country	:	US
Telephone Number	:	813-968-8801
Fax Number	:	813-960-9373

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	02/19/2011

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