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HECTOR JOSE DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9780 N 56TH ST, SUITE C, TEMPLE TERRACE, FL 33617-5508
(813) 549-7465
Mailing address
1808 JAMES REDMANN PRKWY, # 168, PLANT CITY, FL 33563
(813) 757-1290

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
ME0050679
FL
207QA0505X
Adult Medicine Physician
Primary
ME50679
FL
207R00000X
Internal Medicine Physician
ME50679
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03957
BCBS
FL
05
046149100
FL
01
P00217513
RR MCR
Enumeration date
03/08/2006
Last updated
09/15/2016
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