Provider Demographics
NPI:1083687917
Name:DIAZ, CARLOS E (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:DIAZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8740 N KENDALL DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2212
Mailing Address - Country:US
Mailing Address - Phone:305-270-2080
Mailing Address - Fax:305-270-2012
Practice Address - Street 1:8740 N KENDALL DR
Practice Address - Street 2:SUITE 105
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2212
Practice Address - Country:US
Practice Address - Phone:305-270-2080
Practice Address - Fax:305-270-2012
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2015-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME00502232080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371110200Medicaid
FLF39116Medicare UPIN