Provider Demographics
NPI:1285311993
Name:RESSY-DIAZ, ANTONIO (ARNP)
Entity type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:
Last Name:RESSY-DIAZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:MR
Other - First Name:ANTONIO
Other - Middle Name:
Other - Last Name:RESSY-DIAZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:931 W OAK ST STE 103
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4973
Mailing Address - Country:US
Mailing Address - Phone:787-428-6619
Mailing Address - Fax:
Practice Address - Street 1:900 TOWNE CENTER DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3470
Practice Address - Country:US
Practice Address - Phone:407-931-0444
Practice Address - Fax:407-962-4446
Is Sole Proprietor?:No
Enumeration Date:2023-07-04
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11027174363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily