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Individual

MS. DIANA ITACY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
8900 N KENDALL DR, MIAMI, FL 33176-2118
(786) 975-7738
Mailing address
PO BOX 743144, ATLANTA, GA 30384-8054

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9296427
FL

Other

Enumeration date
10/15/2018
Last updated
10/18/2019
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