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General NPI Number Information
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NPI Number | 1134666894
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Entity Type | Individual
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Provider Name | MARIA JOSE DIAZ COLINA
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Gender | Female
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Dates
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Enumeration Date | 01/19/2017
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 8300 W FLAGLER ST STE 170
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City | MIAMI
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State | FL
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Zip | 33144-2098
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Country | US
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Telephone | 786-633-5171
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Fax |
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Provider Business Mailing Address
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Address Line | 7585 SW 152ND AVE APT G104
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City | MIAMI
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State | FL
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Zip | 33193-2373
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Country | US
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Telephone | 305-345-2738
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH25341
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-24-75333
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License Number State | FL
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