Individual
MRS. SAMANTHA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 SE HOSPITAL AVE # 2346, STUART, FL 34994-2346
(772) 287-5200
Mailing address
104 TRAILING OAK TRL, CLAYTON, NC 27527-5313
(727) 900-4901
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
PA9116998
FL
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
11/07/2022
Last updated
03/13/2023
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