Gustavo Adolfo Diaz
Facial Plastic Surgeon
411 N Section St Ste 5
Fairhope
, Alabama 36532-2650
Gustavo Adolfo Diaz
Facial Plastic Surgeon
411 N Section St Ste 5
Fairhope
, Alabama 36532-2650
(251) 753-2209
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About
Features
Specialties
- Facial Plastic Surgeon
Languages spoken
- English
Location
First Address
- Gustavo Adolfo Diaz
- 17026 Carlton Way Rd
- Huntersville, NC
- Zip : 28078
- Phone : (251) 753-2209
Second Address
- Gustavo Adolfo Diaz
- 411 N Section St Ste 5
- Fairhope, AL
- Zip : 36532-2650
- Fax : (251) 517-5049
- Phone : (251) 517-5050
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YS0123X | Facial Plastic Surgeon | 02055 | NC |
| N | 207YS0123X | Facial Plastic Surgeon | 25353 | AL |
| N | 207YS0123X | Facial Plastic Surgeon | ME103280 | FL |
National Provider Identifier
| NPI | 1164599825 |
|---|---|
| Provider Name | Gustavo Adolfo Diaz |
| First Address | Huntersville, NC 28078 |
| Second Address | Fairhope, AL 36532-2650 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/11/2006 |
| Last Update Date | 01/08/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| H77220 | (02) | AL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.