Provider Demographics
NPI:1821185869
Name:DIAZ, ALEJANDRO (MD)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:888 S DOUGLAS RD
Mailing Address - Street 2:APT 1603
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-7510
Mailing Address - Country:US
Mailing Address - Phone:786-374-6755
Mailing Address - Fax:786-624-4105
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:305-662-8368
Practice Address - Fax:786-624-4151
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2013-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL0885892080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000126800Medicaid
FL000126800Medicaid