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NPI Code Detail

MEDICARE: STEVEN DIAZ

MEDICARE:   STEVEN  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
11041C0700XClinical Social WorkerSOW22880FL

General Provider Information

NPI Number : 1962255158
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN DIAZ
Provider Business Mailing Address
First Line : 4725 SW 23RD AVE
Second Line :
City : CAPE CORAL
State : FL
Zip : 33914-6720
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4725 SW 23RD AVE
Second Line :
City : CAPE CORAL
State : FL
Zip : 33914-6720
Country : US
Telephone Number : 217-275-9172
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2024
Last Update Date : 04/08/2024

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Directions to “ STEVEN DIAZ ” Practice Location

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