Provider Demographics
NPI:1437274313
Name:DIAZ FERNANDEZ, MARIA MARGARITA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:MARGARITA
Last Name:DIAZ FERNANDEZ
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 1:151 CALLE CESAR GONZALEZ
Mailing Address - Street 2:PLAZA ANTILLANA APT 4902
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1463
Mailing Address - Country:US
Mailing Address - Phone:787-316-3673
Mailing Address - Fax:
Practice Address - Street 1:151 CALLE CESAR GONZALEZ
Practice Address - Street 2:PLAZA ANTILLANA APT 4902
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1463
Practice Address - Country:US
Practice Address - Phone:787-316-3673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6817208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice