Healthcare Provider Details

I. General information

NPI: 1841541489
Provider Name (Legal Business Name): ZOILA EVARISTA DIAZ-ALVARADO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2012
Last Update Date: 09/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10829 DYLAN LOREN CIR
ORLANDO FL
32825-4442
US

IV. Provider business mailing address

PO BOX 616788
ORLANDO FL
32861-6788
US

V. Phone/Fax

Practice location:
  • Phone: 407-273-7373
  • Fax: 407-770-0675
Mailing address:
  • Phone: 407-630-6925
  • Fax: 407-770-0061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9270629
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: