Individual
KIM DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
8043 MOUNT RANIER DR, JACKSONVILLE, FL 32256-2908
(904) 642-6809
Mailing address
8043 MOUNT RANIER DR, JACKSONVILLE, FL 32256-2908
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6196
FL
Other
Enumeration date
02/02/2013
Last updated
02/02/2013
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