Individual
BORIS D DIEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1414 NW 107TH AVE STE 205, SWEETWATER, FL 33172-2741
(786) 253-9513
(786) 933-6651
Mailing address
16881 SW 278TH ST, HOMESTEAD, FL 33031-2745
(786) 253-9513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
APRN11000018
FL
363LF0000X
Family Nurse Practitioner
APRN11000018
FL
Other
Enumeration date
10/29/2018
Last updated
12/07/2021
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