Provider Demographics
NPI:1265813810
Name:DIAZ, JOSE DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:DANIEL
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 1:2601 SW 37TH AVE STE 907
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2751
Mailing Address - Country:US
Mailing Address - Phone:305-712-6711
Mailing Address - Fax:305-760-4719
Practice Address - Street 1:2601 SW 37TH AVE STE 907
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2751
Practice Address - Country:US
Practice Address - Phone:305-712-6711
Practice Address - Fax:305-760-4719
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME140307207WX0107X, 207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist