Provider Demographics
NPI:1851636294
Name:GONZALEZ DIAZ, WADDY OSVALDO (MD)
Entity Type:Individual
Prefix:
First Name:WADDY
Middle Name:OSVALDO
Last Name:GONZALEZ DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2345 E PRATER WAY STE 207
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-9634
Mailing Address - Country:US
Mailing Address - Phone:775-356-4514
Mailing Address - Fax:775-356-4991
Practice Address - Street 1:2385 E PRATER WAY STE 302
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-9638
Practice Address - Country:US
Practice Address - Phone:775-356-4514
Practice Address - Fax:775-356-4991
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2019-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV19199207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease