Provider Demographics
NPI:1740053602
Name:RAMIREZ-DIAZ, DALTON (DC)
Entity type:Individual
Prefix:DR
First Name:DALTON
Middle Name:
Last Name:RAMIREZ-DIAZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14012 BROGDEN CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-6415
Mailing Address - Country:US
Mailing Address - Phone:407-864-5950
Mailing Address - Fax:
Practice Address - Street 1:801 N MAGNOLIA AVE STE 201
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3842
Practice Address - Country:US
Practice Address - Phone:407-730-5306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14598111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor