Provider Information for 1346624483
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ROBERTO DIAZ LMHC, NCC
Sex: Male
NPI: 1346624483
Last Updated: 2015-07-18
Certification Date:
Certification Date:
Details
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NPI | 1346624483 | ||||||||
Enumeration Date | 2015-07-18 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 2645 EXECUTIVE PARK DR SUITE 513 WESTON, FL 33331-3624 United States Phone: | Fax: | ||||||||
Primary Practice Address | 11850 NW 41ST ST SUNRISE, FL 33323-3612 United States Phone: 954-673-9408 | Fax: | ||||||||
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