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General NPI Number Information
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NPI Number | 1760092381
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Entity Type | Individual
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Provider Name | LINO DIAZ JR. DPT
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Gender | Male
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Dates
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Enumeration Date | 08/07/2020
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 4109 N ARMENIA AVE STE A
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City | TAMPA
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State | FL
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Zip | 33607-6411
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Country | US
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Telephone | 813-588-3342
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Fax | 813-588-3602
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Provider Business Mailing Address
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Address Line | 7045 EVERGREEN WOOD TRAIL
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City | SPRING HILL
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State | FL
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Zip | 34608
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Country | US
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Telephone | 352-596-8371
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT36074
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License Number State | FL
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