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Individual
MARIANA DIAZ
Active
Individual
MARIANA DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2638
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT 2638
PROFESSIONAL LICENSE
FL
Enumeration date
12/30/2015
Last updated
12/30/2015
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