Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | MA 63720 | FL |
NPI | 1275809808 |
---|---|
Provider Name | Yosvany Diaz I |
First Address | Hialeah, FL 33010 |
Second Address | Miami, FL 33125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2012 |
Last Update Date | 28/03/2012 |