Provider Demographics
NPI:1366459596
Name:DIAZ, JULIO J (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:J
Last Name:DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PMB 10
Mailing Address - Street 2:PO BOX 70344
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8344
Mailing Address - Country:US
Mailing Address - Phone:787-754-0315
Mailing Address - Fax:787-763-9871
Practice Address - Street 1:ISAAC GONZALEZ MARTINEZ HOSPITAL CENTRO MEDICO AREA
Practice Address - Street 2:RADIOTERAPIA BASEMENT
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-754-0315
Practice Address - Fax:787-763-8593
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR109072085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR83128Medicare ID - Type Unspecified
PRG04539Medicare UPIN