Individual
LISSETT DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8650 SW 16TH ST, MIAMI, FL 33155-1006
(786) 908-2626
Mailing address
8650 SW 16TH ST, MIAMI, FL 33155-1006
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-20-128840
FL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107963400
—
FL
Enumeration date
09/03/2020
Last updated
01/06/2022
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