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NPI Code Detail

MEDICARE: MR. ALEXIS DIAZ LMHC, CBHCMS, ITDS

MEDICARE: MR. ALEXIS DIAZ LMHC, CBHCMS, ITDS
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
1104100000XSocial Worker
2222Q00000XDevelopmental Therapist
3101YM0800XMental Health CounselorMH25016FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811103351
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALEXIS DIAZ LMHC, CBHCMS, ITDS
Provider Business Mailing Address
First Line : 1550 MADRUGA AVE STE 509
Second Line :
City : CORAL GABLES
State : FL
Zip : 33146-3048
Country : US
Telephone Number : 786-536-9714
Fax Number : 786-536-9833
Provider Business Practice Location Address
First Line : 1550 MADRUGA AVE STE 509
Second Line :
City : CORAL GABLES
State : FL
Zip : 33146-3048
Country : US
Telephone Number : 786-536-9714
Fax Number : 786-536-9833
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2007
Last Update Date : 03/21/2025

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