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CASEY ISABEL DIAZ DE NACIMIENTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8925 COLONIAL CENTER DR STE 1000, FORT MYERS, FL 33905-7813
(239) 343-7400
(239) 468-7942
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-7400
(239) 468-7942

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN11033536
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN110333536
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
123293900
FL
Enumeration date
06/24/2024
Last updated
01/22/2025
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