Individual ProviderLoreta Avinante DiazPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address3623 Keystone Hills Drive, Evansville, IN 47711-2296(812) 475-0864PECOS EnrollmentBased on the most recent information from CMS, provider Loreta Avinante Diaz does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1649368846Provider TypeIndividualFull NameDiaz, Loreta AvinanteTitleMrs.CredentialPTGenderFemaleSole ProprietorNoEnumeration Date10/11/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address3623 Keystone Hills Drive, Evansville, IN 47711-2296Phone(812) 475-0864Fax(812) 475-0864Mailing LocationMailing Address3623 Keystone Hills Drive, Evansville, IN 47711-2296Phone(812) 475-0864Fax(812) 475-0864Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense05003390AIndiana