Provider Demographics
NPI:1407056823
Name:ALLENDE DIAZ, INDIRA NAHIR (MD)
Entity Type:Individual
Prefix:
First Name:INDIRA
Middle Name:NAHIR
Last Name:ALLENDE 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:DOCTORS HOSPITAL CAROLINA
Mailing Address - Street 2:EDIF JESUS T PINERO CALLE MOLINILLO
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988
Mailing Address - Country:US
Mailing Address - Phone:787-406-3965
Mailing Address - Fax:
Practice Address - Street 1:1200 COND VISTA VERDE
Practice Address - Street 2:APT 165
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-406-3965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16850208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice