Individual
MRS. DIANA METROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1674 NW 143RD WAY, PEMBROKE PINES, FL 33028-3009
(954) 397-3785
Mailing address
1674 NW 143RD WAY, PEMBROKE PINES, FL 33028-3009
(954) 397-3785
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8118256 00
—
FL
Enumeration date
02/17/2007
Last updated
11/07/2016
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