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Organization

E.DIAZ DEL VALLE, MD, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARIA SANCHEZ (ADMINISTRATOR)
(787) 744-9787
Entity
Organization

Contact information

Practice address
CONSOLIDATED MALL C 4, AVE GAUTIER BENITEZ, CAGUAS, PR 00725
(787) 744-9787
(787) 744-9787
Mailing address
CONSOLIDATED MALL C 4, AVE GAUTIER BENITEZ, CAGUAS, PR 00725
(787) 744-9787
(787) 744-9787

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
7077
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11511
AMERICAN HEALTH
PR
01
3977
PREFERED MEDICARE CHOICE
PR
01
500210SE
MEDICARE Y MUCHO MAS
PR
01
8667
FIRST PLUS
PR
Enumeration date
02/06/2012
Last updated
02/06/2012
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