Provider Demographics
NPI:1659974459
Name:DIAZ RIZO, FELIPE (APRN)
Entity Type:Individual
Prefix:
First Name:FELIPE
Middle Name:
Last Name:DIAZ RIZO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14690 SPRING HILL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-277-5305
Mailing Address - Fax:
Practice Address - Street 1:14900 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-1018
Practice Address - Country:US
Practice Address - Phone:305-995-0539
Practice Address - Fax:305-995-0538
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009968363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily