Organization
JOSE JUAN DIAZ DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE JUAN DIAZ DO (PRESIDENT)
(954) 564-3200
Entity
Organization
Contact information
Practice address
3308 NE 34TH ST, FORT LAUDERDALE, FL 33308
(954) 564-3200
(954) 653-9188
Mailing address
3308 NE 34TH ST, FORT LAUDERDALE, FL 33308-6906
(954) 564-3200
(954) 653-9188
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
11/30/2012
Last updated
08/16/2018
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