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General NPI Number Information
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NPI Number | 1700723491
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Entity Type | Individual
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Provider Name | KRISTEN M DIAZ NP
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Gender | Female
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 1220 N US HIGHWAY 301
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City | TAMPA
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State | FL
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Zip | 33619-3556
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Country | US
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Telephone | 813-870-4003
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Fax |
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Provider Business Mailing Address
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Address Line | 15310 BALLAST POINT DR APT 3109
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City | FORT MYERS
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State | FL
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Zip | 33908-3453
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Country | US
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Telephone | 484-752-9432
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APRN11044160
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License Number State | FL
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