Provider Demographics
NPI:1467411017
Name:SANCHEZ-DIAZ, PEDRO A (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:A
Last Name:SANCHEZ-DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 W FLAGLER ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2100
Mailing Address - Country:US
Mailing Address - Phone:305-261-8100
Mailing Address - Fax:305-261-3723
Practice Address - Street 1:8080 W FLAGLER ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2100
Practice Address - Country:US
Practice Address - Phone:305-261-8100
Practice Address - Fax:305-261-3723
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0054806174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650270011OtherMIDWAY PEDIATRICS TAX ID
FLE67825OtherVISTA HEALTH PLAN
FL016527OtherAV-MED
FL09380OtherBLUE CROSS & BLUE SHIELD
FL1227OtherHUMANA
FL061381900Medicaid
FL004194OtherNEIGHBORHOOD PARTNERSHIP
FL213208OtherAMERIGROUP
FL551026OtherAETNA