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General NPI Number Information
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NPI Number | 1003238916
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Entity Type | Individual
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Provider Name | LATOYA DIAZ
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Gender | Female
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Dates
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Enumeration Date | 01/11/2014
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 100 COMMERCIAL DR
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City | KEYSTONE HEIGHTS
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State | FL
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Zip | 32656-6802
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Country | US
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Telephone | 352-473-6595
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Fax | 352-473-6597
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Provider Business Mailing Address
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Address Line | 149 NW 166TH TER
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City | NEWBERRY
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State | FL
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Zip | 32669-6109
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Country | US
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Telephone | 352-474-1891
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11034769
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN9322582
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License Number State | FL
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