Provider Demographics
NPI:1659702207
Name:OFICINA MEDICO PRIMARIO DR. EDUARDO DIAZ CSP
Entity Type:Organization
Organization Name:OFICINA MEDICO PRIMARIO DR. EDUARDO DIAZ CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-263-0965
Mailing Address - Street 1:CALLE 4 E8 BONEVILLE TERRACE
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-263-0965
Mailing Address - Fax:787-735-7613
Practice Address - Street 1:108 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-263-0965
Practice Address - Fax:787-735-7613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty