Provider Demographics
NPI:1407800063
Name:DIAZ-ALBET, BERTA (MD)
Entity Type:Individual
Prefix:DR
First Name:BERTA
Middle Name:
Last Name:DIAZ-ALBET
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 1:3191 CORAL WAY
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3213
Mailing Address - Country:US
Mailing Address - Phone:305-461-6060
Mailing Address - Fax:305-461-5911
Practice Address - Street 1:440 W 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3603
Practice Address - Country:US
Practice Address - Phone:305-828-5000
Practice Address - Fax:305-461-5911
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0042637207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0042637OtherMEDICAL LICENSE
FLME0042637OtherMEDICAL LICENSE
FLD27977Medicare UPIN
FLAD5948104OtherDEA