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Individual

JESUS DIAZ VARGAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
202 E 17TH ST, HIALEAH, FL 33010-3138
(786) 782-5653
Mailing address
202 E 17TH ST, HIALEAH, FL 33010-3138
(786) 782-5653

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCM.0106500-P
FL

Other

Enumeration date
03/05/2024
Last updated
03/05/2024
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