Provider Demographics
NPI:1407019342
Name:DIAZ, ZOBEIDA M (MD)
Entity Type:Individual
Prefix:
First Name:ZOBEIDA
Middle Name:M
Last Name:DIAZ
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 1:2 DUDLEY ST STE 560
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3230
Mailing Address - Country:US
Mailing Address - Phone:401-453-7955
Mailing Address - Fax:401-453-7720
Practice Address - Street 1:2 DUDLEY ST STE 560
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3230
Practice Address - Country:US
Practice Address - Phone:401-453-7955
Practice Address - Fax:401-453-7720
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD136432084P0800X
WI572662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry