Individual
MRS. MIDIALA E DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12376 QUAIL ROOST DR, MIAMI, FL 33177
(786) 623-0994
(786) 430-8197
Mailing address
6100 BLUE LAGOON DR STE 365, MIAMI, FL 33126-7010
(786) 322-7333
(786) 322-7329
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME130934
FL
282N00000X
General Acute Care Hospital
31573R
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0021581600
—
FL
Enumeration date
12/12/2014
Last updated
03/09/2021
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