Provider Demographics
NPI:1922594167
Name:DIAZ, OMAR RAMOS (MSN, NP-C)
Entity Type:Individual
Prefix:MR
First Name:OMAR
Middle Name:RAMOS
Last Name:DIAZ
Suffix:
Gender:M
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26110 EMERY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5788
Mailing Address - Country:US
Mailing Address - Phone:440-368-6868
Mailing Address - Fax:440-368-6866
Practice Address - Street 1:26110 EMERY RD STE 300
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5788
Practice Address - Country:US
Practice Address - Phone:440-368-6868
Practice Address - Fax:440-368-6866
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023101363LG0600X, 363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health