Provider Demographics
NPI:1073292546
Name:DIAZ BEHAVIORAL THERAPY SERVICES INC
Entity Type:Organization
Organization Name:DIAZ BEHAVIORAL THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISMERY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ ANDINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-808-9456
Mailing Address - Street 1:4844 NW 4TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2171
Mailing Address - Country:US
Mailing Address - Phone:863-808-9456
Mailing Address - Fax:
Practice Address - Street 1:4844 NW 4TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2171
Practice Address - Country:US
Practice Address - Phone:863-808-9456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty