Individual
DIEGO J BOUZAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5631 SPRING RUN AVE, ORLANDO, FL 32819-7166
(407) 267-0113
(407) 530-0153
Mailing address
5631 SPRING RUN AVE, ORLANDO, FL 32819-7166
(407) 267-0113
(407) 530-0153
Taxonomy
Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
471024324
TAX ID
FL
Enumeration date
07/22/2014
Last updated
09/16/2014
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