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General NPI Number Information
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NPI Number | 1851921605
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Entity Type | Individual
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Provider Name | STEVEN DIAZ PTA
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Gender | Male
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Dates
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Enumeration Date | 01/21/2020
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Last Update Date | 01/21/2020
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Provider Practice Location Address
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Address Line | 2051 NW 112TH AVE STE 125
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City | MIAMI
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State | FL
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Zip | 33172-1835
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Country | US
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Telephone | 305-878-0083
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Fax |
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Provider Business Mailing Address
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Address Line | 6081 W 24TH AVE APT 203
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City | HIALEAH
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State | FL
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Zip | 33016-6901
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Country | US
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Telephone | 786-372-5308
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 29792
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License Number State | FL
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