MEDICARE: NATALIE 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	101Y00000X	Counselor
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1619317617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE DIAZ

Provider Business Mailing Address
First Line	:	2468 SW 137TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6330
Country	:	US
Telephone Number	:	786-832-6630
Fax Number	:

Provider Business Practice Location Address
First Line	:	2468 SW 137TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6330
Country	:	US
Telephone Number	:	786-832-6630
Fax Number	:

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

Provider Enumeration Date	:	07/05/2013
Last Update Date	:	04/22/2019

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Directions to “ NATALIE DIAZ ” Practice Location

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