Provider Demographics
NPI:1225355811
Name:PAZ, DIANA E
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:E
Last Name:PAZ
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 1:4343 W FLAGLER ST
Mailing Address - Street 2:SUITE 506
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1586
Mailing Address - Country:US
Mailing Address - Phone:305-446-7898
Mailing Address - Fax:
Practice Address - Street 1:4343 W FLAGLER ST
Practice Address - Street 2:SUITE 506
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1586
Practice Address - Country:US
Practice Address - Phone:305-446-7898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-22
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 41968225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA 41968OtherMASSAGE THERAPIST