Organization
ROLANDO E DIAZ MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROLANDO E DIAZ MD (PRESIDENT)
(305) 512-0080
Entity
Organization
Contact information
Practice address
4410 W 16TH AVE, SUITE 56, HIALEAH, FL 33012-7100
(305) 512-0080
(305) 512-0082
Mailing address
PO BOX 940700, MIAMI, FL 33194-0700
(305) 512-0080
(305) 512-0082
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME95472
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME95472
STATE LICENSE
FL
Enumeration date
03/02/2009
Last updated
07/20/2009
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