Organization
CARLOS E.DIAZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNA THEISEN (ACCOUNT)
(786) 475-3973
Entity
Organization
Contact information
Practice address
8740 N KENDALL DR, 105, MIAMI, FL 33176-2212
(305) 270-2080
(305) 270-2012
Mailing address
8740 N KENDALL DR, 105, MIAMI, FL 33176-2212
(305) 270-2080
(305) 270-2012
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
ME0050223
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371110200
—
FL
Enumeration date
03/18/2015
Last updated
03/18/2015
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