Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 26034 | PR |
N | 2084N0400X | Neurologist | 104466 | MN |
N | 2084N0400X | Neurologist | 52194 | MN |
Y | 2084N0402X | Child Neurologist | ME125884 | FL |
N | 2084N0402X | Child Neurologist | P3707 | TX |
NPI | 1265630735 |
---|---|
Provider Name | Dr. Gloria E Diaz-Medina |
First Address | Miami, FL 33155-3009 |
Second Address | Miami, FL 33155-3009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2007 |
Last Update Date | 25/04/2018 |