Provider Demographics
NPI:1205863149
Name:DIAZ, DILMER (MD)
Entity Type:Individual
Prefix:DR
First Name:DILMER
Middle Name:
Last Name:DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 SW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7439
Mailing Address - Country:US
Mailing Address - Phone:352-873-6729
Mailing Address - Fax:352-873-1188
Practice Address - Street 1:3201 SW 34TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7439
Practice Address - Country:US
Practice Address - Phone:352-873-6729
Practice Address - Fax:352-873-1188
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97897208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C59965Medicare UPIN