Organization
ALBERT G LOGUN M D HUBERT G MARTINEZ M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE LUIS DIAZ D.O. (PRESIDENT)
(305) 821-6112
Entity
Organization
Contact information
Practice address
7100 W 20TH AVE STE 401, HIALEAH, FL 33016-1811
(305) 821-6112
(305) 821-6112
Mailing address
7100 W 20TH AVE STE 401, HIALEAH, FL 33016-1811
(305) 821-6112
(305) 821-9050
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS7912
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019928600
—
FL
Enumeration date
06/23/2006
Last updated
03/17/2018
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