Individual provider Active NPI

Diyah Du

  • Contractor
  • Plantation, FL
National Provider Identifier
1154665404
Registry record updated Jul 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
MA29514 Issued in FL
Practice address
1856 N Nob Hill Rd
# 317
Plantation, FL 33322-6548
Phone
(954) 444-2659
NPI assigned
Nov 26, 2012
Last updated
Jul 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X MA29514 FL Primary

Addresses

Primary practice location

1856 N Nob Hill Rd
# 317
Plantation, FL 33322-6548

Mailing address

1856 N Nob Hill Rd
# 317
Plantation, FL 33322-6548
Phone (954) 444-2659

Other names 1

  • Dba Mint Condition 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
MA29514FLMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468108800000",
    "number": "1154665404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1856 N NOB HILL RD",
            "address_2": "# 317",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333226548",
            "telephone_number": "954-444-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1856 N NOB HILL RD",
            "address_2": "# 317",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333226548",
            "telephone_number": "954-444-2659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DU",
        "first_name": "DIYAH",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2016-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "FL",
            "license": "MA29514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DBA MINT",
            "last_name": "CONDITION",
            "credential": "LMT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2016; 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.