Provider Demographics
NPI:1841068731
Name:SERRAT, DIANA LAURA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:LAURA
Last Name:SERRAT
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 1:4612 SW 82ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5447
Mailing Address - Country:US
Mailing Address - Phone:786-256-0061
Mailing Address - Fax:
Practice Address - Street 1:93911 OVERSEAS HWY STE 8
Practice Address - Street 2:
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-3025
Practice Address - Country:US
Practice Address - Phone:786-419-9609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician