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General NPI Number Information
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NPI Number | 1497569404
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Entity Type | Individual
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Provider Name | MICHELLE DIAZ NRCPT
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Gender | Female
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 407-204-1776
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Fax | 888-272-4513
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Provider Business Mailing Address
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Address Line | 2328 MID TOWN TER APT 1032
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City | ORLANDO
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State | FL
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Zip | 32839-4527
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Country | US
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Telephone | 407-535-7684
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | E3222554
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | S3F6N6G3
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License Number State | FL
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