Provider Demographics
NPI:1457501066
Name:DIAZ, ANAMARIE
Entity Type:Individual
Prefix:
First Name:ANAMARIE
Middle Name:
Last Name:DIAZ
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:CENTRO DE PATOLOGIA DEL HABLA Y AUDICION
Mailing Address - Street 2:CENTRO COMERCIAL HUMACAO SUITE 100 AVE. FONT MARTELO
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-0000
Mailing Address - Country:US
Mailing Address - Phone:787-285-3978
Mailing Address - Fax:787-285-3978
Practice Address - Street 1:CENTRO DE PATOLOGIA DEL HABLA Y AUDICION
Practice Address - Street 2:CENTRO COMERCIAL HUMACAO SUITE 100 AVE. FONT MARTELO
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-0000
Practice Address - Country:US
Practice Address - Phone:787-285-3978
Practice Address - Fax:787-285-3978
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR537231H00000X
PR601235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist