Provider Demographics
NPI:1891860243
Name:DIAS, DALILA N
Entity Type:Individual
Prefix:
First Name:DALILA
Middle Name:N
Last Name:DIAS
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 1:265 S FEDERAL HWY
Mailing Address - Street 2:#164
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4146
Mailing Address - Country:US
Mailing Address - Phone:954-599-1098
Mailing Address - Fax:
Practice Address - Street 1:3050 NE 48TH CT
Practice Address - Street 2:#406
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-7970
Practice Address - Country:US
Practice Address - Phone:954-599-1098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT17639225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5692Medicare ID - Type Unspecified
FLU2516ZMedicare UPIN