Provider Demographics
NPI:1508067679
Name:OMS, JUAN DIEGO (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:DIEGO
Last Name:OMS
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 1:8271 NW 34TH DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1371
Mailing Address - Country:US
Mailing Address - Phone:305-807-9459
Mailing Address - Fax:
Practice Address - Street 1:22790 SW 112TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-7602
Practice Address - Country:US
Practice Address - Phone:305-235-2616
Practice Address - Fax:305-235-6178
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1019172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry