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General NPI Number Information
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NPI Number | 1285507392
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Entity Type | Individual
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Provider Name | LUISA MARAY PENA DIAZ APRN
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Gender | Female
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 2550 SIMPSON RD
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City | KISSIMMEE
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State | FL
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Zip | 34744-4637
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Country | US
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Telephone | 407-632-4217
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Fax | 407-632-4226
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Provider Business Mailing Address
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Address Line | PO BOX 4189
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-4189
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Country | US
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Telephone | 954-363-9582
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Fax | 954-363-9663
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11042096
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License Number State | FL
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