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Individual

GIOVANNIE MIGUEL DIAZ LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
URB LA SIERRA DEL RIO C/3-D8, SAN JUAN, PR 00926
(787) 902-4591
Mailing address
300 AVE LA SIERRA APT 37, SAN JUAN, PR 00926-4337
(787) 902-4591

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
073619
PR
163W00000X
Registered Nurse
9632260
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
003690
PR
367500000X
Certified Registered Nurse Anesthetist
11027017
FL

Other

Enumeration date
08/14/2023
Last updated
08/14/2023
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