Healthcare Provider Details

I. General information

NPI: 1750821344
Provider Name (Legal Business Name): CYNTHIA I DIAZ PINEIRO APRNI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 11/02/2021
Certification Date: 11/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

394 HAVENDALE BLVD
AUBURNDALE FL
33823-4527
US

IV. Provider business mailing address

6100 BLUE LAGOON DR STE 365
MIAMI FL
33126-7010
US

V. Phone/Fax

Practice location:
  • Phone: 863-327-0131
  • Fax: 863-777-2307
Mailing address:
  • Phone: 786-322-7333
  • Fax: 863-413-1971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9445191
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: