Provider Demographics
NPI:1912306374
Name:DIAZ HEARING, INC.
Entity type:Organization
Organization Name:DIAZ HEARING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, 100 OWNERSHIP
Authorized Official - Prefix:
Authorized Official - First Name:TERESITA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-621-4253
Mailing Address - Street 1:8870 SW 40TH ST
Mailing Address - Street 2:SUITE #7
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5465
Mailing Address - Country:US
Mailing Address - Phone:786-621-4253
Mailing Address - Fax:
Practice Address - Street 1:8870 SW 40TH ST
Practice Address - Street 2:SUITE #7
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5465
Practice Address - Country:US
Practice Address - Phone:786-621-4253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS2802237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL610170400Medicaid