Individual
DR. IVYA E DIAZ VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD INTERNAL MEDICINE
Contact information
Practice address
AVE LUIS MUNOZ MARIN 50, QUADRANGLE MEDICAL SUITE 106, CAQUAS, PR 00726
(787) 745-0022
(787) 739-7199
Mailing address
AVE LUIS MUNOZ MARIN 50, QUADRANGLE MEDICAL SUITE 106, CAQUAS, PR 00726
(787) 745-0022
(787) 739-7199
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10789
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0400592
—
PR
Enumeration date
11/28/2006
Last updated
12/18/2012
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