Provider Demographics
NPI:1992039648
Name:DR. DIAZ DUVAL P. S. C.
Entity Type:Organization
Organization Name:DR. DIAZ DUVAL P. S. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:SIGFREDO
Authorized Official - Middle Name:R
Authorized Official - Last Name:DIAZ DUVAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-306-7006
Mailing Address - Street 1:PO BOX 1746
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-1746
Mailing Address - Country:US
Mailing Address - Phone:787-306-7006
Mailing Address - Fax:787-713-9045
Practice Address - Street 1:CALLE T. DELFAUS # 46
Practice Address - Street 2:
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-1746
Practice Address - Country:US
Practice Address - Phone:787-734-2090
Practice Address - Fax:787-713-9045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7391261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center