Provider Demographics
NPI:1033886825
Name:SENA-DIAZ, AMBER NATALIE
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:NATALIE
Last Name:SENA-DIAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:NATALIE
Other - Last Name:SENA-DIAZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4901 VINELAND RD STE 150
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-7190
Mailing Address - Country:US
Mailing Address - Phone:407-707-5018
Mailing Address - Fax:407-707-8658
Practice Address - Street 1:4901 VINELAND RD STE 150
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-7190
Practice Address - Country:US
Practice Address - Phone:407-707-5018
Practice Address - Fax:407-707-8658
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant