Healthcare Provider Details

I. General information

NPI: 1518510106
Provider Name (Legal Business Name): ADALYS DIAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2019
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10625 N MILITARY TRL STE 207
PALM BEACH GARDENS FL
33410-6552
US

IV. Provider business mailing address

10625 N MILITARY TRL STE 207
PALM BEACH GARDENS FL
33410-6552
US

V. Phone/Fax

Practice location:
  • Phone: 561-895-1660
  • Fax: 561-934-7037
Mailing address:
  • Phone: 561-895-1660
  • Fax: 561-934-7037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number4232
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: