Provider Demographics
NPI:1164804787
Name:DIAZ MORALES, KEILA N (MD)
Entity Type:Individual
Prefix:
First Name:KEILA
Middle Name:N
Last Name:DIAZ MORALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:410 CELEBRATION PL STE 302
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5435
Mailing Address - Country:US
Mailing Address - Phone:407-303-3824
Mailing Address - Fax:407-303-3825
Practice Address - Street 1:410 CELEBRATION PL STE 302
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5435
Practice Address - Country:US
Practice Address - Phone:407-303-3824
Practice Address - Fax:407-303-3825
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME145642208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery