Individual
DENNIS F. DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2864 WELLNESS AVE STE 200, ORANGE CITY, FL 32763-8335
(386) 775-0333
(386) 775-0427
Mailing address
2864 WELLNESS AVE STE 200, ORANGE CITY, FL 32763-8335
(386) 775-0333
(386) 775-0427
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME107205
FL
208600000X
Surgery Physician
TRN7966
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002287400
—
FL
01
—
208600000X
TAXONOMY CODE
FL
05
—
277915300
—
FL
Enumeration date
01/03/2007
Last updated
01/31/2020
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