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Individual

DR. LESLIE KENT DIAZ SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
4150 TAMIAMI TRL S, VENICE, FL 34293-5130
(941) 497-5555
(941) 497-2369
Mailing address
4150 TAMIAMI TRL S, VENICE, FL 34293-5130
(941) 497-5555
(941) 497-2369

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
001028
FL

Other

Enumeration date
08/16/2012
Last updated
08/16/2012
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