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General NPI Number Information
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NPI Number | 1275880957
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Entity Type | Individual
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Provider Name | ELIZABETH ROSAS-DIAZ M.S., CCC-SLP TSSLD
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Gender | Female
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 10/22/2021
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Provider Practice Location Address
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Address Line | 33243 SAND CREEK DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-4518
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Country | US
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Telephone | 347-308-3716
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Fax |
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Provider Business Mailing Address
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Address Line | 33243 SAND CREEK DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-4518
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Country | US
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Telephone | 347-308-3716
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 18352
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 027789-1
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License Number State | NY
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