Provider Demographics
NPI:1073383477
Name:SANZO, DIANA L
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:L
Last Name:SANZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 W 56TH ST APT 3117
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6921
Mailing Address - Country:US
Mailing Address - Phone:786-362-2300
Mailing Address - Fax:
Practice Address - Street 1:1910 W 56TH ST APT 3117
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6921
Practice Address - Country:US
Practice Address - Phone:786-362-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-316504106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician