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General NPI Number Information
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NPI Number | 1821805664
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Entity Type | Individual
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Provider Name | VANESSA DIAZ
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Gender | Female
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 8271 SW 35TH TER
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City | MIAMI
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State | FL
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Zip | 33155-3344
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Country | US
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Telephone | 305-397-3733
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Fax |
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Provider Business Mailing Address
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Address Line | 13620 SW 101ST LN
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City | MIAMI
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State | FL
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Zip | 33186-2814
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Country | US
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Telephone | 786-205-0227
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMT4290
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License Number State | FL
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