Wanda Ivelisse Diaz

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

930 Issued in PR

Practice address

759 Ave Avelino Vicente
San Juan, PR 00909-2538

Phone

(787) 410-5443

NPI assigned

Mar 12, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1992046171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2510",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007772510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 AVE AVELINO VICENTE",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092538",
            "telephone_number": "787-410-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "WANDA",
        "middle_name": "IVELISSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "PR",
            "license": "930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Solimar Diaz, M.D.
• Veronica Diaz, M.S.W.
• Victor Ivan Diaz Jr.
• Waleska Diaz, MSW
• Wanda Diaz, BS, RPH, LND, CDE
• Wilfredo Diaz, MD
• Yamilette Diaz
• Zaida Yadira Diaz
• Idamy Yaritza Dieppa, PHARMD
• Renan A. Dieppa, MD

• Pediatric Occupational Therapist in San Juan, PR
• Providers in San Juan, PR by specialty
• Pediatric Occupational Therapist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.