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General NPI Number Information
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NPI Number | 1316609118
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Entity Type | Individual
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Provider Name | TATIANA REJES DIAZ PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/08/2021
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Last Update Date | 10/08/2021
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Provider Practice Location Address
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Address Line | 8745 LITTLE RD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34654-4947
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Country | US
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Telephone | 727-264-5224
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 NE 17TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33909-5604
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Country | US
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Telephone | 239-699-5314
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS63357
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License Number State | FL
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