Provider Demographics
NPI:1801822234
Name:DIAZ, CAROLINA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CAROLINA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CAROLINA
Other - Middle Name:
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:401 E ST SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-3242
Mailing Address - Country:US
Mailing Address - Phone:202-698-9010
Mailing Address - Fax:202-698-9103
Practice Address - Street 1:401 E ST SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-3242
Practice Address - Country:US
Practice Address - Phone:202-698-9010
Practice Address - Fax:202-698-9103
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA030951363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical