MEDICARE: MISS DANIELA DIAZ RBT

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	106S00000X	Behavior Technician	D200160056870	FL

General Provider Information

NPI Number	:	1932911088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DANIELA DIAZ RBT

Provider Business Mailing Address
First Line	:	1509 NE 6TH AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-1012
Country	:	US
Telephone Number	:	239-560-4744
Fax Number	:

Provider Business Practice Location Address
First Line	:	1509 NE 6TH AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-1012
Country	:	US
Telephone Number	:	239-560-4744
Fax Number	:

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

Provider Enumeration Date	:	01/24/2025
Last Update Date	:	01/24/2025

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Directions to “ MISS DANIELA DIAZ RBT” Practice Location

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