Provider Demographics
NPI:1508123803
Name:HANSON, DIANA MAY (CRT)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:MAY
Last Name:HANSON
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:MISS
Other - First Name:DIANA
Other - Middle Name:MAY
Other - Last Name:CARBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16263 89TH PL N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-1757
Mailing Address - Country:US
Mailing Address - Phone:786-367-3190
Mailing Address - Fax:561-790-1491
Practice Address - Street 1:16263 89TH PL N
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-1757
Practice Address - Country:US
Practice Address - Phone:786-367-3190
Practice Address - Fax:561-790-1491
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT30792278C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedCritical Care