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General NPI Number Information
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NPI Number | 1598474876
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Entity Type | Individual
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Provider Name | CATALINA DIAZ-CARDENAS
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Gender | Female
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 3855 S US HIGHWAY 1
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City | FORT PIERCE
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State | FL
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Zip | 34982-6621
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Country | US
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Telephone | 772-462-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 5150 NW MILNER DR
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-3392
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Country | US
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Telephone | 772-462-3800
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH29022
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License Number State | FL
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