Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 2010019175 | MO |
N | 208600000X | Surgeon | 2010019175 | MO |
Y | 2086S0120X | Pediatric Surgery | DR.0062681 | CO |
NPI | 1407167695 |
---|---|
Provider Name | Dr. Jose Luis Diaz-Miron |
First Address | Aurora, CO 80045-2527 |
Second Address | Aurora, CO 80045-2527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2010 |
Last Update Date | 22/07/2019 |