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General NPI Number Information
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NPI Number | 1528770278
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Entity Type | Individual
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Provider Name | JULIO DIAZ
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Gender | Male
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 15924 SW 92ND AVE
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1842
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Country | US
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Telephone | 305-964-5824
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Fax | 786-452-1200
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Provider Business Mailing Address
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Address Line | 1335 W 49TH PL APT 404
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City | HIALEAH
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State | FL
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Zip | 33012-3131
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Country | US
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Telephone | 865-234-5747
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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