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General NPI Number Information
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NPI Number | 1235869454
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Entity Type | Individual
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Provider Name | JESSE ALBERT DIAZ-FRANCO I LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/11/2022
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Last Update Date | 06/11/2022
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Provider Practice Location Address
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Address Line | 1750 ARCADIA RD
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City | HOLIDAY
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State | FL
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Zip | 34690-6052
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Country | US
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Telephone | 727-939-8387
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Fax |
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Provider Business Mailing Address
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Address Line | 8380 PHILADELPHIA AVE
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City | SPRING HILL
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State | FL
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Zip | 34608-5452
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Country | US
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Telephone | 352-585-0626
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW20030
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License Number State |
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