Provider Demographics
NPI:1558799387
Name:CURTIS, MARY DIAZ (ARNP-C)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:DIAZ
Last Name:CURTIS
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 PINELLAS ST STE 250
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3367
Mailing Address - Country:US
Mailing Address - Phone:727-462-3701
Mailing Address - Fax:727-298-6278
Practice Address - Street 1:455 PINELLAS ST
Practice Address - Street 2:SUITE 250
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3367
Practice Address - Country:US
Practice Address - Phone:727-462-3700
Practice Address - Fax:727-298-6707
Is Sole Proprietor?:No
Enumeration Date:2013-10-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9220070363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010255800Medicaid
FLHQ268ZMedicare PIN
FLHQ268YMedicare PIN