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1386387900
DIEGO MEDERO GOMEZ
TAMPA, FL
NPI
1386387900
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-04-20
Last Update Date
2022-04-20
Business Address
DIEGO MEDERO GOMEZ
10135 MONTAGUE ST
TAMPA, FL 33626-1857
Phone number: 813-401-2539
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Mailing Address
DIEGO MEDERO GOMEZ
2901 W OHIO AVE
TAMPA, FL 33607-6720
Phone number: 813-420-4907
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