Provider Demographics
NPI:1851383913
Name:DIAZ, MARIA (DO PHARMD)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:DO PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9415 NE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138
Mailing Address - Country:US
Mailing Address - Phone:305-756-7899
Mailing Address - Fax:305-756-7898
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:SUITE 860
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4556
Practice Address - Country:US
Practice Address - Phone:305-604-2888
Practice Address - Fax:305-604-2887
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8226207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL06337YOtherMEDICARE IND.
FL262657800Medicaid
FLH54026Medicare UPIN
FLK5246Medicare ID - Type Unspecified