Healthcare Provider Details

I. General information

NPI: 1649045386
Provider Name (Legal Business Name): DAYANA DIAZ FALCON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2023
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 78TH AVE N STE 6
PINELLAS PARK FL
33781-2407
US

IV. Provider business mailing address

3412 E JEAN ST
TAMPA FL
33610-1624
US

V. Phone/Fax

Practice location:
  • Phone: 727-317-7916
  • Fax:
Mailing address:
  • Phone: 813-439-7781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: