Provider Demographics
NPI:1730116039
Name:DIAZ-RISPLER, NANETTE C (DPM)
Entity Type:Individual
Prefix:DR
First Name:NANETTE
Middle Name:C
Last Name:DIAZ-RISPLER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:NANETTE
Other - Middle Name:C
Other - Last Name:RISPLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:1521 FOREST HILL BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6031
Mailing Address - Country:US
Mailing Address - Phone:613-579-3305
Mailing Address - Fax:561-935-1583
Practice Address - Street 1:1521 FOREST HILL BLVD STE 4
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6031
Practice Address - Country:US
Practice Address - Phone:561-357-9330
Practice Address - Fax:561-935-1583
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0002464213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPO2464OtherMEDICAL LICENSE
FL390251000OtherMEDICAID ID
65390ZMedicare ID - Type Unspecified