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General NPI Number Information
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NPI Number | 1508635418
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Entity Type | Organization
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Legal Business Name | B & DIAZ ENTERPRISES LLC
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 03/12/2024
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Provider Practice Location Address
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Address Line | 6700 S FLORIDA AVE STE 14
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City | LAKELAND
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State | FL
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Zip | 33813-3311
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Country | US
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Telephone | 954-562-1025
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Fax |
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Provider Business Mailing Address
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Address Line | 6700 S FLORIDA AVE STE 14
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City | LAKELAND
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State | FL
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Zip | 33813-3311
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Country | US
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Telephone | 863-606-1933
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. GASPAR DIAZ
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Credential |
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Telephone | 954-562-1025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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