Individual
DR. GERARDO DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
14201 S DIXIE HWY, PALMETTO BAY, FL 33176-7224
(786) 227-6396
(786) 227-6456
Mailing address
22112 SW 130TH CT, MIAMI, FL 33170-2694
(305) 978-6309
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME 103459
FL
208D00000X
General Practice Physician
Primary
ME103459
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ID: 138 851 733
—
FL
Enumeration date
03/19/2009
Last updated
10/30/2023
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