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Individual

ADILEN DIAZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
75 W 19TH ST, HIALEAH, FL 33010-2638
(305) 632-0322
Mailing address
75 W 19TH ST, HIALEAH, FL 33010-2638
(305) 632-0322

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-207130
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
113920500
FL
Enumeration date
09/07/2022
Last updated
09/07/2022
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