MEDICARE: ANA FLABIA SOCAS 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	106S00000X	Behavior Technician	24-321773	FL

General Provider Information

NPI Number	:	1801635818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA FLABIA SOCAS DIAZ

Provider Business Mailing Address
First Line	:	7210 N LOIS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-3161
Country	:	US
Telephone Number	:	813-468-0370
Fax Number	:

Provider Business Practice Location Address
First Line	:	7210 N LOIS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-3161
Country	:	US
Telephone Number	:	813-468-0370
Fax Number	:

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

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	05/20/2024

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Directions to “ ANA FLABIA SOCAS DIAZ ” Practice Location

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