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General NPI Number Information
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NPI Number | 1609682145
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Entity Type | Individual
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Provider Name | YUDEX DIAZ
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Gender | Female
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 900 W 49TH ST STE 548
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City | HIALEAH
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State | FL
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Zip | 33012-3442
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Country | US
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Telephone | 786-213-6008
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Fax |
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Provider Business Mailing Address
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Address Line | 13160 SW 64TH TER APT 1610
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City | MIAMI
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State | FL
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Zip | 33183-5635
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Country | US
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Telephone | 786-213-6008
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 9522489
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 9522489
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License Number State | FL
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