Diosark, Inc | |
1546 42nd St West Palm Beach FL 33407-3604 | |
(561) 840-1647 | |
(561) 840-6415 |
Full Name | Diosark, Inc |
---|---|
Speciality | Behavior Analyst |
Location | 1546 42nd St, West Palm Beach, Florida |
Authorized Official Name and Position | Bernadette Watson (ADMINISTRATOR) |
Authorized Official Contact | 5618401647 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Diosark, Inc Po Box 221315 West Palm Beach FL 33422-1315 Ph: (561) 840-1647 | Diosark, Inc 1546 42nd St West Palm Beach FL 33407-3604 Ph: (561) 840-1647 |
NPI Number | 1013305952 |
---|---|
Provider Enumeration Date | 12/30/2014 |
Last Update Date | 12/30/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013305952 | NPI | - | NPPES |
674307296 | Other | FL | MEDWAIVER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | 674307296 (Florida) | Primary |
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