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NPI Code Detail

MEDICARE: DORIS DIAZ

MEDICARE:   DORIS  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
1103K00000XBehavior AnalystFL
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1821532441
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORIS DIAZ
Provider Business Mailing Address
First Line : 4230 SW 101ST AVE
Second Line :
City : MIAMI
State : FL
Zip : 33165-5053
Country : US
Telephone Number : 813-389-6218
Fax Number :
Provider Business Practice Location Address
First Line : 4230 SW 101ST AVE
Second Line :
City : MIAMI
State : FL
Zip : 33165-5053
Country : US
Telephone Number : 813-389-6218
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2016
Last Update Date : 03/30/2018

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Directions to “ DORIS DIAZ ” Practice Location

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