Provider Demographics
NPI:1720769714
Name:ZAYAS DIAZ, NADGI LOREL
Entity type:Individual
Prefix:
First Name:NADGI
Middle Name:LOREL
Last Name:ZAYAS DIAZ
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 1:5150 SW 107TH LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476
Mailing Address - Country:US
Mailing Address - Phone:443-561-5244
Mailing Address - Fax:
Practice Address - Street 1:7480 SW STATE RD 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476
Practice Address - Country:US
Practice Address - Phone:352-547-8644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFB9794552225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist