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NPI Code Detail

MEDICARE: DIANA COURSON BS

MEDICARE: DIANA COURSON BS
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
1104100000XSocial Worker

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 : 1508808148
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA COURSON BS
Provider Business Mailing Address
First Line : 18356 NW 47TH AVE
Second Line :
City : MIAMI GARDENS
State : FL
Zip : 33055-2934
Country : US
Telephone Number : 786-953-4612
Fax Number : 786-953-8534
Provider Business Practice Location Address
First Line : 17567 S DIXIE HWY
Second Line :
City : MIAMI
State : FL
Zip : 33157-5435
Country : US
Telephone Number : 786-293-9544
Fax Number : 786-293-9594
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2006
Last Update Date : 05/18/2016

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Directions to “ DIANA COURSON BS” Practice Location

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