Individual
YANETSY A DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1051 E 19TH ST, HIALEAH, FL 33013-4315
(786) 370-0576
Mailing address
1051 E 19TH ST, HIALEAH, FL 33013-4315
(786) 370-0576
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA62249
MASSAGE THERAPIST
FL
Enumeration date
03/11/2011
Last updated
03/11/2011
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