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DORYSEL DIAZ DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
476 E 61ST ST, HIALEAH, FL 33013-1137
(786) 491-8674
Mailing address
6202 NW 194TH ST, HIALEAH, FL 33015-8128
(786) 491-8674

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11028901
FL

Other

Enumeration date
01/06/2020
Last updated
04/09/2024
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