Provider Demographics
NPI:1902159320
Name:DIANNE CLAY
Entity Type:Organization
Organization Name:DIANNE CLAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOME HEALTH/ MEDICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-394-2397
Mailing Address - Street 1:7441 CLARCONA OCOEE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-1211
Mailing Address - Country:US
Mailing Address - Phone:407-394-2397
Mailing Address - Fax:407-290-9509
Practice Address - Street 1:7441 CLARCONA OCOEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-1211
Practice Address - Country:US
Practice Address - Phone:407-394-2397
Practice Address - Fax:407-290-9509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility