Provider Demographics
NPI:1689427650
Name:DIAZ NAVARRO, MELANY
Entity Type:Individual
Prefix:
First Name:MELANY
Middle Name:
Last Name:DIAZ NAVARRO
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 1:4600 ARCIE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-1906
Mailing Address - Country:US
Mailing Address - Phone:786-440-0420
Mailing Address - Fax:
Practice Address - Street 1:4600 ARCIE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-1906
Practice Address - Country:US
Practice Address - Phone:786-440-0420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician