Provider Demographics
NPI:1679099675
Name:DIAZ, GUELSY
Entity Type:Individual
Prefix:
First Name:GUELSY
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GUELSY
Other - Middle Name:
Other - Last Name:DIAZ FARIAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:8870 SW 40TH ST STE 7
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5465
Mailing Address - Country:US
Mailing Address - Phone:786-621-4253
Mailing Address - Fax:
Practice Address - Street 1:8870 SW 40TH ST STE 7
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5465
Practice Address - Country:US
Practice Address - Phone:786-621-4253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4929237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist