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1205536893
IVAN DIAZ
KISSIMMEE, FL
NPI
1205536893
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225400000X Rehabilitation Practitioner
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2023-03-03
Last Update Date
2023-04-06
Business Address
IVAN DIAZ
1621 E VINE ST
KISSIMMEE, FL 34744-3730
Phone number: 407-847-4152
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Mailing Address
IVAN DIAZ
1621 E VINE ST
KISSIMMEE, FL 34744-3730
Phone number:
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