Individual
DR. MANUEL LOPEZ DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9333 SW 152ND ST, EMERGENCY DEPARTMENT, PALMETTO BAY, FL 33157-1778
(305) 256-5001
Mailing address
3103 SW 156TH PL, MIAMI, FL 33185-4920
(305) 226-7431
(888) 959-7905
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0083364
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264971300
—
FL
01
—
28010
BCBS
FL
01
—
P00414260
RR MCR
—
Enumeration date
01/17/2006
Last updated
05/01/2017
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