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General NPI Number Information
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NPI Number | 1265730410
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Entity Type | Individual
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Provider Name | PEDRO ENRIQUE DIAZ-HERRERA LMT
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Gender | Male
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 2260 SW 8TH ST STE 301
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City | MIAMI
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State | FL
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Zip | 33135-4938
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Country | US
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Telephone | 788-353-2604
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Fax | 786-353-2645
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Provider Business Mailing Address
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Address Line | 2260 SW 8TH ST STE 301
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City | MIAMI
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State | FL
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Zip | 33135-4938
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Country | US
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Telephone | 788-353-2604
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Fax | 786-353-2645
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 46170
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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