Provider Demographics
NPI:1578215026
Name:DI MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:DI MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANCEBO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-239-4273
Mailing Address - Street 1:6101 SW 153RD COURT RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-2577
Mailing Address - Country:US
Mailing Address - Phone:786-356-1853
Mailing Address - Fax:
Practice Address - Street 1:6101 SW 153RD COURT RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-2577
Practice Address - Country:US
Practice Address - Phone:786-356-1853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty