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Organization
DIOSARK, INC
Active
Organization
DIOSARK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNADETTE WATSON (ADMINISTRATOR)
(561) 840-1647
Entity
Organization
Contact information
Practice address
1546 42ND ST, WEST PALM BEACH, FL 33407-3604
(561) 840-1647
(561) 840-6415
Mailing address
PO BOX 221315, WEST PALM BEACH, FL 33422-1315
(561) 840-1647
(561) 840-6415
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
674307296
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
674307296
MEDWAIVER
FL
Enumeration date
12/30/2014
Last updated
12/30/2014
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