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Individual

DR. ROSENDO DIEGO DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
801 E DIXIE AVE, SUITE 104, LEESBURG, FL 34748-7601
(352) 365-2583
(352) 728-6749
Mailing address
734 N 3RD ST, SUITE 115, LEESBURG, FL 34748-5285
(352) 365-2583
(352) 728-6749

Taxonomy

Speciality
Code
Description
License number
State
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
40028
FL
2085N0700X
Neuroradiology Physician
ME40028
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME40028
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046908400
FL
01
300133479
RR MEDICARE RACF
FL
01
300133480
RR MEDICARE LMIV
FL
Enumeration date
05/04/2006
Last updated
02/24/2016
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