Provider Demographics
NPI:1548241052
Name:DIAZ, RITA MARIA (MD FAAAA&I)
Entity Type:Individual
Prefix:MISS
First Name:RITA
Middle Name:MARIA
Last Name:DIAZ
Suffix:
Gender:F
Credentials:MD FAAAA&I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568-B JUAN J JIMENEZ
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919
Mailing Address - Country:US
Mailing Address - Phone:787-763-8939
Mailing Address - Fax:787-765-4418
Practice Address - Street 1:568-B JUAN J JIMENEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919
Practice Address - Country:US
Practice Address - Phone:787-763-8939
Practice Address - Fax:787-765-4418
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR37582080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology