# JORGE O DIAZ MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396754172
- **Authorized official:** JORGE ORLANDO DIAZ MD (OWNER)
- **Authorized official phone:** (407) 444-4848

## Contact information

- **Practice address:** 1331 S INTERNATIONAL PKWY STE 1261, LAKE MARY, FL 32746-1405
- **Practice address phone:** (407) 444-4848
- **Practice address fax:** (407) 444-4870
- **Mailing address:** 5224 W STATE ROAD 46, SANFORD, FL 32771-9230
- **Mailing address phone:** (407) 444-4848
- **Mailing address fax:** (407) 444-4870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | NULL | Yes |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/07/2006
- **Last updated:** 09/08/2021