Individual
LISA MARIE DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
17401 COMMERCE PARK BLVD STE 104, TAMPA, FL 33647-3507
(813) 751-0777
(813) 377-1727
Mailing address
38135 MARKET SQ, ZEPHYRHILLS, FL 33542-7505
(352) 567-0188
(813) 355-5101
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS13514
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2015
Last updated
08/25/2021
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