Individual
NILS M DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 MAIN ST, MS-417, DUNEDIN, FL 34698-5848
(727) 734-6635
Mailing address
PO BOX 198317, ATLANTA, GA 30384-8317
(727) 734-6635
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
ME59531
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374111700
—
FL
Enumeration date
12/13/2006
Last updated
05/05/2010
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