=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841123072
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELISSA DEVORA DIAZ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2026
-----------------------------------------------------
Last Update Date | 09/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2208 OASIS PALM CIR APT 201
-----------------------------------------------------
City | CAPE CORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33991-3396
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-567-2055
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2208 OASIS PALM CIR APT 201
-----------------------------------------------------
City | CAPE CORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33991-3396
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-567-2055
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number | RBT-26-539998
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------