Individual
DR. DIANA DE LA VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4175 W 20TH AVE, HIALEAH, FL 33012-5874
(305) 825-0300
Mailing address
1901 BRICKELL AVE # P42, MIAMI, FL 33129-1724
(305) 858-1287
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME56204
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036896200
—
FL
Enumeration date
02/21/2007
Last updated
11/30/2011
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