Provider Demographics
NPI:1790863660
Name:DIAZ, ROBERT ENOCH (ARNP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ENOCH
Last Name:DIAZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 SW 38TH AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1530
Mailing Address - Country:US
Mailing Address - Phone:786-409-4135
Mailing Address - Fax:786-497-4485
Practice Address - Street 1:3150 SW 38TH AVE STE 800
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33146-1530
Practice Address - Country:US
Practice Address - Phone:786-409-4135
Practice Address - Fax:786-497-4485
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2898002363LA2100X
FLARNP2898002363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAK552ZMedicare UPIN