Individual
DERRIK JOSE DIAZ NAVARRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4742
(813) 396-9459
Mailing address
1151 DARNABY WAY, ORLANDO, FL 32824-5035
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/27/2019
Last updated
02/27/2019
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