Individual
KELLY DIAZ-VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
8550 NE 138TH LN BLDG 500, LADY LAKE, FL 32159-8957
(352) 633-9858
Mailing address
8550 NE 138TH LN BLDG 500, LADY LAKE, FL 32159-8957
(352) 333-9858
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11027606
FL
Other
Enumeration date
09/08/2023
Last updated
10/18/2023
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