Provider Demographics
NPI:1275042129
Name:DIAZ, ALMA J (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ALMA
Middle Name:J
Last Name:DIAZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 E RIVIERA BLVD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-5815
Mailing Address - Country:US
Mailing Address - Phone:787-564-4488
Mailing Address - Fax:
Practice Address - Street 1:250 S CHICKASAW TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-3503
Practice Address - Country:US
Practice Address - Phone:407-380-3466
Practice Address - Fax:407-200-8849
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-22
Last Update Date:2017-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13732225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty