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Individual

TONY DIAZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
7100 W 20TH AVE, STE 101, HIALEAH, FL 33016-1897
(305) 822-0401
(305) 824-1748
Mailing address
7100 W 20TH AVE, STE 101, HIALEAH, FL 33016-1897
(305) 822-0401
(305) 824-1748

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
OS6699
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
046716
NEIGHBORHOOD HEALTH
FL
05
264540800
FL
01
288361
AVMED
FL
01
3395788
AETNA HMO
FL
01
47987
BCBS
FL
01
591272217
HUMANA
FL
01
7708523
AETNA PPO
FL
Enumeration date
06/09/2005
Last updated
12/06/2009
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