MEDICARE: IVETTE DIEZ HAGE

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	374U00000X	Home Health Aide		FL

General Provider Information

NPI Number	:	1295694750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVETTE DIEZ HAGE

Provider Business Mailing Address
First Line	:	5401 COLLINS AVE APT 223
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2530
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5401 COLLINS AVE APT 223
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2530
Country	:	US
Telephone Number	:	786-784-5585
Fax Number	:

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

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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