Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SW 14273 | FL |
NPI | 1003067711 |
---|---|
Provider Name | Mr. Osvail L Dias |
First Address | Lauderdale By The Sea, FL 33308-5415 |
Second Address | Lauderdale By The Sea, FL 33308-4451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2008 |
Last Update Date | 10/03/2017 |