Provider Demographics
NPI:1306040126
Name:DIAZ ROZETT, HILDAMARY (MD)
Entity Type:Individual
Prefix:
First Name:HILDAMARY
Middle Name:
Last Name:DIAZ ROZETT
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 1:305 CALLE VILLAMIL APT 712
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-2856
Mailing Address - Country:US
Mailing Address - Phone:787-746-3848
Mailing Address - Fax:
Practice Address - Street 1:CARR 189 KM 2.0
Practice Address - Street 2:PARQUE INDUSTRIAL CAGUAX
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-746-3848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17744208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics