Individual
DR. JESUS ANTONIO DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7000 W 12TH AVE, SUITE 6, HIALEAH, FL 33014-5154
(305) 557-5888
(305) 818-6677
Mailing address
1402 SE 17TH AVE, HOMESTEAD, FL 33035-2211
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN11799
FL
Other
Enumeration date
05/15/2007
Last updated
05/25/2021
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