Healthcare Provider Details

I. General information

NPI: 1669295408
Provider Name (Legal Business Name): ROSMERY DIAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2024
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 SW 74TH CT STE 1906
MIAMI FL
33156-3178
US

IV. Provider business mailing address

16345 SW 78TH TER
MIAMI FL
33193-3425
US

V. Phone/Fax

Practice location:
  • Phone: 305-842-2283
  • Fax: 305-503-7338
Mailing address:
  • Phone: 786-222-3139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11035204
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: