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General NPI Number Information
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NPI Number | 1134402498
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Entity Type | Individual
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Provider Name | DIANA C RAD RPH
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Gender | Female
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | 8300 PARK BLVD
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City | DORAL
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State | FL
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Zip | 33126-3832
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Country | US
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Telephone | 305-269-7825
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Fax | 305-269-7834
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Provider Business Mailing Address
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Address Line | 12260 SW 98TH ST
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City | MIAMI
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State | FL
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Zip | 33186-2530
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Country | US
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Telephone | 305-271-2185
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS 22157
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License Number State | FL
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