Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | OS10982 | FL |
N | 208000000X | Pediatrician | 0S10982 | FL |
N | 2080P0204X | Pediatric Emergency Doctor | OS10982 | FL |
NPI | 1679882427 |
---|---|
Provider Name | Dr. Lisabet Diaz |
First Address | Hialeah, FL 33013-3722 |
Second Address | Miami, FL 33155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2010 |
Last Update Date | 22/05/2018 |