Organization
DIAMOND HEART INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATEF FARAH MITRY (PRESIDENT)
(386) 767-0557
Entity
Organization
Contact information
Practice address
3959 S NOVA RD, SUITE #1, PORT ORANGE, FL 32129
(386) 767-0557
(386) 767-3251
Mailing address
PO BOX 290274, PORT ORANGE, FL 32129
(386) 767-0557
(386) 767-3251
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT10588
FL
Other
Enumeration date
03/26/2007
Last updated
08/22/2020
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