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NPI Code Detail

MEDICARE: ALEXIS DIAZ CAC, CTP

MEDICARE: ALEXIS DIAZ CAC, CTP
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
1101YA0400XAddiction (Substance Use Disorder) Counselor0100308FL
2101YA0400XAddiction (Substance Use Disorder) Counselor003786FL

General Provider Information

NPI Number : 1588516694
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS DIAZ CAC, CTP
Provider Business Mailing Address
First Line : 2311 N ORANGE BLOSSOM TRL
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-2313
Country : US
Telephone Number : 407-957-9077
Fax Number : 888-702-0079
Provider Business Practice Location Address
First Line : 2311 N ORANGE BLOSSOM TRL
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-2313
Country : US
Telephone Number : 407-957-9077
Fax Number : 888-702-0079
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/11/2026

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