| Doctor Name: | MRS. DIANE DIAZ RODRIGUEZ |
| NPI Number: | 1093176893 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | IMH 14439 |
| License Number: | IMH 14439 |
| Business Practice Address: | 167 Ridgemont Cir Se Palm Bay, FL - 329092318 |
| Business Phone Number: | 8503136207 |
| Business Fax Number: | |
| Mailing Address: | 1009 Maitland Center Commons Blvd Ste 212, MAITLAND |
| State: | FL |
| Postal Code: | 327517270 |
| Phone Number: | 8503136207 |
| Fax Number: | |
| NPI Enumeration Date: | 03/08/2016 |
| NPI Last Update Date: | 03/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | IMH 14439 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |