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NPI Code Detail

MEDICARE: DIAZ-MORENO ENTERPRISES, LLC

MEDICARE: DIAZ-MORENO ENTERPRISES, LLC
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
1235Z00000XSpeech-Language PathologistSA7971FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174048755
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIAZ-MORENO ENTERPRISES, LLC
Provider Business Mailing Address
First Line : 1251 W FOREST LAKE DR
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32714-2837
Country : US
Telephone Number : 407-346-6530
Fax Number :
Provider Business Practice Location Address
First Line : 1251 W FOREST LAKE DR
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32714-2837
Country : US
Telephone Number : 407-346-6530
Fax Number :
Authorized Official
Title or Position : OWNER, THERAPIST
Name : MRS. ELIZABETH DIAZ-MORENO
Credential : M.S., CCC-SLP
Telephone Number : 407-346-6530
Provider Enumeration Date : 08/04/2017
Last Update Date : 07/21/2022

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Directions to “DIAZ-MORENO ENTERPRISES, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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