MEDICARE: SARAH MARIE SOLIS DIAZ

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	225100000X	Physical Therapist	PT44145	FL

General Provider Information

NPI Number	:	1396603080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MARIE SOLIS DIAZ

Provider Business Mailing Address
First Line	:	348 CANNA DR
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33897-3821
Country	:	US
Telephone Number	:	787-515-0969
Fax Number	:

Provider Business Practice Location Address
First Line	:	3015 CYPRESS GARDENS RD
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-2258
Country	:	US
Telephone Number	:	863-268-6523
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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