Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DN 19871 | FL |
NPI | 1063757698 |
---|---|
Provider Name | Dr. Giuliana Diaz Jones |
First Address | Indian River Shores, FL 32963-1229 |
Second Address | Vero Beach, FL 32963-1400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2012 |
Last Update Date | 18/11/2017 |