Organization
JOSE M DIAZ-DIAZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE M DIAZ-DIAZ MD (PRACTITIONER)
(787) 306-4284
Entity
Organization
Contact information
Practice address
1614 WEAVER DR, LUTZ, FL 33559-3334
(787) 306-4284
Mailing address
1614 WEAVER DR, LUTZ, FL 33559-3334
(787) 306-4284
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
ME122262
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497792162
NPI
PR
Enumeration date
09/11/2016
Last updated
09/11/2016
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