MEDICARE: CHRISTOPHER DIAZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		FL

General Provider Information

NPI Number	:	1114727427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER DIAZ

Provider Business Mailing Address
First Line	:	2601 NW 16TH STREET RD APT 440
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-1486
Country	:	US
Telephone Number	:	786-975-0953
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 NW 16TH STREET RD APT 440
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-1486
Country	:	US
Telephone Number	:	786-975-0953
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2025
Last Update Date	:	03/18/2025

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Directions to “ CHRISTOPHER DIAZ ” Practice Location

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