Provider Demographics
NPI:1457307100
Name:DIAZ RODRIGUEZ, ZENAIDA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ZENAIDA
Middle Name:
Last Name:DIAZ RODRIGUEZ
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:AVE DOMENECH 383
Mailing Address - Street 2:
Mailing Address - City:HATO REY
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-758-4005
Mailing Address - Fax:787-758-5150
Practice Address - Street 1:AVE DOMENECH 383
Practice Address - Street 2:
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-758-4005
Practice Address - Fax:787-758-5150
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6603208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C78206Medicare UPIN
0097875Medicare ID - Type Unspecified