Individual
ANISLEY LANZA DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2715 W SLIGH AVE, TAMPA, FL 33614-2852
(813) 403-2567
Mailing address
1419 W WATERS AVE STE 117, TAMPA, FL 33604-2852
(813) 403-2567
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9582094
FL
163WM1400X
Nurse Massage Therapist (NMT)
Primary
RN9582094
FL
208100000X
Physical Medicine & Rehabilitation Physician
MA89791
FL
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
MA89791
FL
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
MA89791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L523000825290
CAR INSURANCE
FL
Enumeration date
09/04/2019
Last updated
09/24/2024
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