Provider Demographics
NPI:1497082705
Name:CANDIDO F DIAZ-CRUZ MD PA
Entity Type:Organization
Organization Name:CANDIDO F DIAZ-CRUZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDIDO
Authorized Official - Middle Name:F
Authorized Official - Last Name:DIAZ-CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-275-5072
Mailing Address - Street 1:8950 N KENDALL DR
Mailing Address - Street 2:STE 304W
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2144
Mailing Address - Country:US
Mailing Address - Phone:305-275-5072
Mailing Address - Fax:305-275-5075
Practice Address - Street 1:8950 N KENDALL DR
Practice Address - Street 2:STE 304W
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2144
Practice Address - Country:US
Practice Address - Phone:305-275-5072
Practice Address - Fax:305-275-5075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0025369207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty