Provider Demographics
NPI:1437771565
Name:DIAZ, JOSE ALBERTO (PA)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ALBERTO
Last Name:DIAZ
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Gender:M
Credentials:PA
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Mailing Address - Street 1:COND. VEREDAS DEL PARQUE
Mailing Address - Street 2:408 BLVD.MEDIA LUNA APT.4803
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-4972
Mailing Address - Country:US
Mailing Address - Phone:787-776-2454
Mailing Address - Fax:787-946-5385
Practice Address - Street 1:COND. VEREDAS DEL PARQUE
Practice Address - Street 2:408 BLVD.MEDIA LUNA APT.4803
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-4972
Practice Address - Country:US
Practice Address - Phone:787-776-2454
Practice Address - Fax:787-946-5385
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical