Individual
MELBA DIAZ REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7205 N CORTEZ AVE, TAMPA, FL 33614-2638
(813) 625-4362
Mailing address
7205 N CORTEZ AVE, TAMPA, FL 33614-2638
(813) 625-4362
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/29/2011
Last updated
06/29/2011
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