MEDICARE: KAREN 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	235Z00000X	Speech-Language Pathologist	30003537	NC

General Provider Information

NPI Number	:	1942025036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN DIAZ

Provider Business Mailing Address
First Line	:	101 STEPHANIE DR APT N
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27511-4902
Country	:	US
Telephone Number	:	954-588-9687
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 CHATHAM ST
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-4335
Country	:	US
Telephone Number	:	919-774-1281
Fax Number	:

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

Provider Enumeration Date	:	11/22/2024
Last Update Date	:	11/22/2024

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Directions to “ KAREN DIAZ ” Practice Location

Language	Start Address	Practice Location

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