Individual
CARLOS DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
6009 W FERN ST, TAMPA, FL 33634-5136
(813) 841-0143
Mailing address
6009 W FERN ST, TAMPA, FL 33634
(813) 841-0143
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA61242
FL
Other
Enumeration date
01/21/2011
Last updated
01/21/2011
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