Provider Demographics
NPI:1578189320
Name:DIAZ RODRIGUEZ, TAHNEE (PMHNP)
Entity Type:Individual
Prefix:
First Name:TAHNEE
Middle Name:
Last Name:DIAZ RODRIGUEZ
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 NW 53RD ST STE 341
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4791
Mailing Address - Country:US
Mailing Address - Phone:786-417-9395
Mailing Address - Fax:
Practice Address - Street 1:7950 NW 53RD ST STE 341
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-4791
Practice Address - Country:US
Practice Address - Phone:786-417-9395
Practice Address - Fax:305-397-0960
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9480108363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health