Organization
JORGE O. DIAZ, MD PA
Active
Parent organization
JORGE O. DIAZ, MD PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
JORGE O. DIAZ, MD PA
Authorized official
JORGE O. DIAZ MD (AUTHORIZED OFFICIAL)
(407) 444-4848
Entity
Organization
Contact information
Practice address
1825 SALK AVE, TAVARES, FL 32778-4311
(407) 444-4848
(407) 444-4870
Mailing address
5224 SR 46 # 376, SANFORD, FL 32771-9230
(407) 444-4848
(407) 444-4870
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015249701
—
FL
Enumeration date
07/20/2021
Last updated
11/15/2023
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