Healthcare Provider Details

I. General information

NPI: 1285556977
Provider Name (Legal Business Name): SHARLEINE DIAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 MOCKINGBIRD RD UNIT B
KEY LARGO FL
33037-3831
US

IV. Provider business mailing address

1220 MOCKINGBIRD RD UNIT B
KEY LARGO FL
33037-3831
US

V. Phone/Fax

Practice location:
  • Phone: 786-282-6279
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2833230
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: