MEDICARE: YADIGNA 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	103K00000X	Behavior Analyst	1-25-84958	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1598456261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YADIGNA DIAZ

Provider Business Mailing Address
First Line	:	PO BOX 963
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32756-0963
Country	:	US
Telephone Number	:	844-668-6222
Fax Number	:	888-975-0599

Provider Business Practice Location Address
First Line	:	2785 S BAY ST STE A
Second Line	:
City	:	EUSTIS
State	:	FL
Zip	:	32726-6591
Country	:	US
Telephone Number	:	844-668-6222
Fax Number	:	888-975-0599

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

Provider Enumeration Date	:	05/15/2023
Last Update Date	:	01/08/2026

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Directions to “ YADIGNA DIAZ ” Practice Location

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