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General NPI Number Information
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NPI Number | 1992530364
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Entity Type | Individual
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Provider Name | GEIDY DIAZ MEDINA
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Gender | Female
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Dates
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Enumeration Date | 09/05/2024
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 508 ROGER WILLIAMS RD
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City | APOPKA
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State | FL
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Zip | 32703-5502
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Country | US
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Telephone | 786-695-8704
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Fax |
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Provider Business Mailing Address
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Address Line | 7628 SOUTHWICK ST
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City | ORLANDO
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State | FL
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Zip | 32818-4748
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Country | US
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Telephone |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 24337586
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License Number State | FL
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