Provider Demographics
NPI:1033854369
Name:MANOHAR DIAZ, KIARA GABRIELA (MD)
Entity Type:Individual
Prefix:DR
First Name:KIARA
Middle Name:GABRIELA
Last Name:MANOHAR DIAZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 CARMEN STREET
Mailing Address - Street 2:URB. VILLA AUXERRE
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683
Mailing Address - Country:US
Mailing Address - Phone:939-208-3217
Mailing Address - Fax:
Practice Address - Street 1:47 CARMEN STREET
Practice Address - Street 2:URB. VILLA AUXERRE
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:939-208-3217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program