De La Vega, Diana

De La Vega, Diana is an individual health care provider with primary practice located at 4175 W 20Th Ave , Hialeah FL 33012-5874. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. De La Vega, Diana can be contacted via phone (305) 825-0300.

Contact Information

Primary practice address
4175 W 20Th Ave Hialeah FL 33012-5874
Phone: (305) 825-0300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME56204 Florida

Profile Details

NPI number 1952446205
LBN Legal business name De La Vega, Diana
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2007
Last updated Nov 30th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952446205 NPPES
Florida MEDICAID 036896200

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