Individual provider Active NPI

Samara L Diaz, RMFT

  • Marriage & Family Therapist
  • Weston, FL
National Provider Identifier
1013733187
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4932 Issued in FL
Practice address
2731 Executive Park Dr Ste 9
Weston, FL 33331-3659
Phone
(754) 272-5889
NPI assigned
Nov 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4932 FL Primary

Addresses

Primary practice location

2731 Executive Park Dr Ste 9
Weston, FL 33331-3659

Mailing address

12608 NW 98TH PL
Hialeah Gardens, FL 33018-7416
Phone (786) 925-5111

Other names 1

  • Ms. Samara Loris Diaz Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4932FLMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1013733187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12608 NW 98TH PL",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330187416",
            "telephone_number": "786-925-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2731 EXECUTIVE PARK DR STE 9",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313659",
            "telephone_number": "754-272-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "SAMARA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "RMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "4932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMARA",
            "last_name": "DIAZ",
            "middle_name": "LORIS",
            "prefix": "MS.",
            "credential": "RMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Weston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.