Provider Demographics
NPI:1598340606
Name:RETINA CONSULTANTS OF MIAMI
Entity Type:Organization
Organization Name:RETINA CONSULTANTS OF MIAMI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAIN PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-712-6711
Mailing Address - Street 1:950 BRICKELL BAY DR APT 5007
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3963
Mailing Address - Country:US
Mailing Address - Phone:305-794-6117
Mailing Address - Fax:
Practice Address - Street 1:2601 SW 37TH AVE STE 907
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2751
Practice Address - Country:US
Practice Address - Phone:305-712-6711
Practice Address - Fax:305-760-4719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty