Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | ME0050223 | FL |
NPI | 1083687917 |
---|---|
Provider Name | Carlos E. Diaz |
First Address | Miami, FL 33176-2212 |
Second Address | Miami, FL 33176-2212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 18/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
371110200 | (05) | FL |
F39116 | (02) | FL |