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Individual

VANESSA DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9738 MONTAGUE ST, TAMPA, FL 33626-1868
(813) 298-8778
(813) 475-4328
Mailing address
9738 MONTAGUE ST, TAMPA, FL 33626-1868
(813) 298-8778
(813) 475-4328

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
232135
FL

Other

Enumeration date
10/16/2011
Last updated
10/16/2011
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