MEDICARE: ANGEL DAYAN 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	106S00000X	Behavior Technician	RBT24322529	FL

General Provider Information

NPI Number	:	1942064753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGEL DAYAN DIAZ

Provider Business Mailing Address
First Line	:	10900 SW 196TH ST APT 310
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-8135
Country	:	US
Telephone Number	:	786-329-9772
Fax Number	:

Provider Business Practice Location Address
First Line	:	10900 SW 196TH ST APT 310
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-8135
Country	:	US
Telephone Number	:	786-329-9772
Fax Number	:

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

Provider Enumeration Date	:	02/12/2024
Last Update Date	:	02/12/2024

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Directions to “ ANGEL DAYAN DIAZ ” Practice Location

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