Healthcare Provider Details

I. General information

NPI: 1790585990
Provider Name (Legal Business Name): VALERIE DIAZ PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3663 S MIAMI AVE
MIAMI FL
33133-4237
US

IV. Provider business mailing address

11264 SW 26TH ST
MIAMI FL
33165-2234
US

V. Phone/Fax

Practice location:
  • Phone: 305-316-0620
  • Fax:
Mailing address:
  • Phone: 305-316-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11038469
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: