Healthcare Provider Details

I. General information

NPI: 1861296295
Provider Name (Legal Business Name): JUANA LAZO DIAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5180 NW 7TH ST APT 607
MIAMI FL
33126-3348
US

IV. Provider business mailing address

5180 NW 7TH ST APT 607
MIAMI FL
33126-3348
US

V. Phone/Fax

Practice location:
  • Phone: 786-451-2256
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: