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NPI Code Detail

MEDICARE: EILEEN DIAZ

MEDICARE: EILEEN 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
1103T00000XPsychologist

General Provider Information

NPI Number : 1700940970
Entity Type Code : Individual
Provider Name (Legal Business Name) : EILEEN DIAZ
Provider Business Mailing Address
First Line : 10231 NEWINGTON DR
Second Line :
City : ORLANDO
State : FL
Zip : 32836-3745
Country : US
Telephone Number : 140-723-5549
Fax Number :
Provider Business Practice Location Address
First Line : 7208 W SAND LAKE RD STE 305
Second Line :
City : ORLANDO
State : FL
Zip : 32819-5279
Country : US
Telephone Number : 407-235-5498
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2006
Last Update Date : 09/25/2022

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Directions to “ EILEEN DIAZ ” Practice Location

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