MEDICARE: ALEJANDRA DIAZ OSORIO

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	:	1306698881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRA DIAZ OSORIO

Provider Business Mailing Address
First Line	:	3040 NW 212TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-1135
Country	:	US
Telephone Number	:	786-707-1497
Fax Number	:

Provider Business Practice Location Address
First Line	:	3040 NW 212TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-1135
Country	:	US
Telephone Number	:	786-707-1497
Fax Number	:

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

Provider Enumeration Date	:	04/05/2024
Last Update Date	:	04/05/2024

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Directions to “ ALEJANDRA DIAZ OSORIO ” Practice Location

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