Individual
IAN DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3501 JOHNSON ST, HOLLYWOOD, FL 33021-5421
(954) 987-2000
Mailing address
11200 SW 8TH ST # 3-342, MIAMI, FL 33199-2516
(305) 348-7747
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11024169
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/19/2021
Last updated
03/15/2023
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