Individual
MR. IFRAIN DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2346 GREENBRIER ST, DELTONA, FL 32738-8736
(407) 401-9860
Mailing address
2346 GREENBRIER ST, DELTONA, FL 32738-8736
(386) 956-6045
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
D200-400-73-175-1
FL
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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