Individual
JASON LEE DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3690 DAVIE BLVD, FORT LAUDERDALE, FL 33312-3440
(954) 833-0010
Mailing address
2210 SW 87TH WAY, MIRAMAR, FL 33025-2020
(954) 665-7003
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9115038
FL
Other
Enumeration date
10/12/2021
Last updated
11/22/2022
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