Individual
ANITA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
410 10TH AVE W, PALMETTO, FL 34221-5032
(941) 722-3582
(941) 729-8322
Mailing address
410 10TH AVE W, PALMETTO, FL 34221-5032
(941) 722-3582
(941) 729-8322
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10521
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890133300
—
FL
Enumeration date
09/25/2007
Last updated
11/22/2011
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