Individual
KEVIN DAVID DIANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2884 WELLNESS AVE, ORANGE CITY, FL 32763-8426
(386) 774-4404
(386) 774-4496
Mailing address
120 WILLOWBAY RIDGE ST, SANFORD, FL 32771-7990
(321) 662-1174
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
17272
FL
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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