Healthcare Provider Details

I. General information

NPI: 1124196282
Provider Name (Legal Business Name): DIANA L DALY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6211 TANAGER PLACE
TEMPLE TERRACE FL
33617
US

IV. Provider business mailing address

6211 TANAGER PL
TEMPLE TERRACE FL
33617-9300
US

V. Phone/Fax

Practice location:
  • Phone: 813-767-2373
  • Fax: 813-985-7026
Mailing address:
  • Phone: 813-767-2373
  • Fax: 813-985-7026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA6227
License Number StateFL

VIII. Authorized Official

Name: DIANA LYNN DALY
Title or Position: PRESIDENT/THERAPIST
Credential: MS CCC SLP
Phone: 813-767-2373