Most Relevant Information
Provider Data
| NPI Number: | 1003648098 |
| Provider Name: | DIEGO CORAL |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/17/2024 |
| Last Updated: | 08/17/2024 |
Provider Practice Location
7601 N FEDERAL HWY STE 150A
BOCA RATON
FL
334871663
Practice Location Phone/Fax
| Phone: | 7543998507 |
| Fax: |
Provider Mailing Location
3605 NW 17TH WAY APT 105
OAKLAND PARK
FL
333095863
Provider Mailing Phone/Fax
| Phone: | 9547084933 |
| Fax: |