MEDICARE: MARIA DIAZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	372600000X	Adult Companion
3	3747A0650X	Attendant Care Provider
4	3747P1801X	Personal Care Attendant
5	376J00000X	Homemaker
6	253J00000X	Foster Care Agency

General Provider Information

NPI Number	:	1821625799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA DIAZ

Provider Business Mailing Address
First Line	:	3155 E PATRICK LN STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3481
Country	:	US
Telephone Number	:	702-992-0576
Fax Number	:

Provider Business Practice Location Address
First Line	:	3155 E PATRICK LN STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120
Country	:	US
Telephone Number	:	702-992-0576
Fax Number	:

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

Provider Enumeration Date	:	03/23/2020
Last Update Date	:	05/04/2021

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Directions to “ MARIA DIAZ ” Practice Location

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