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Individual

ADISLEY DIAZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.D

Contact information

Practice address
4995 NW 72ND AVE, 409, MIAMI, FL 33166-5643
(305) 599-5258
Mailing address
4995 NW 72ND AVE, 409, MIAMI, FL 33166-5643
(305) 599-5258
(305) 599-5259

Taxonomy

Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
HCC9762
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HCC9762
AHCA
FL
Enumeration date
05/03/2013
Last updated
05/03/2013
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