Individual
EDWIN DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12500 N DALE MABRY HWY STE D, TAMPA, FL 33618-2809
(813) 528-4960
(813) 355-5088
Mailing address
38135 MARKET SQUARE DR, ZEPHYRHILLS, FL 33542-7505
(813) 528-4960
(813) 355-5088
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11016751
FL
363LF0000X
Family Nurse Practitioner
APRN11016751
FL
Other
Enumeration date
11/19/2021
Last updated
11/16/2023
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