Organization
JORGE O DIAZ MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE ORLANDO DIAZ MD (OWNER)
(407) 444-4848
Entity
Organization
Contact information
Practice address
1331 S INTERNATIONAL PKWY STE 1261, LAKE MARY, FL 32746-1405
(407) 444-4848
(407) 444-4870
Mailing address
5224 W STATE ROAD 46, SANFORD, FL 32771-9230
(407) 444-4848
(407) 444-4870
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF7204
RAILROAD MEDICARE
FL
Enumeration date
08/07/2006
Last updated
09/08/2021
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