Organization
MANUEL DIEZ, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL J DIEZ LOPEZ MD (PRESIDENT)
(954) 462-8030
Entity
Organization
Contact information
Practice address
800 E BROWARD BLVD STE 608, FT LAUDERDALE, FL 33301-2029
(954) 462-8030
(954) 462-8090
Mailing address
800 E BROWARD BLVD STE 608, FT LAUDERDALE, FL 33301-2029
(954) 462-8030
(954) 462-8090
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME27360
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588767115
NPI
FL
Enumeration date
04/25/2007
Last updated
08/22/2020
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