Provider Demographics
NPI:1275601007
Name:DIAZ, YOLYMAR (SLP-A)
Entity Type:Individual
Prefix:
First Name:YOLYMAR
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1957 BELLKNOLL LN
Mailing Address - Street 2:
Mailing Address - City:KINDRED
Mailing Address - State:FL
Mailing Address - Zip Code:34744-6181
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1107 MABBETTE ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5161
Practice Address - Country:US
Practice Address - Phone:407-201-8079
Practice Address - Fax:407-343-9180
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI32062355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant