Individual
DR. JORGE B DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8011 N HIMES AVE STE 4, TAMPA, FL 33614-2700
(813) 488-1414
(813) 488-1413
Mailing address
8011 N HIMES AVE STE 4, TAMPA, FL 33614-2700
(813) 488-1414
(813) 488-1413
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ACN671
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ACN671
MEDICAL LICENSE
FL
Enumeration date
06/22/2015
Last updated
03/28/2019
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