Provider Demographics
NPI:1013272830
Name:DR. ANGEL DIAZ-NORRMAN, D.D.S., PA
Entity Type:Organization
Organization Name:DR. ANGEL DIAZ-NORRMAN, D.D.S., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ-NORRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-227-4020
Mailing Address - Street 1:9100 CORAL WAY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2066
Mailing Address - Country:US
Mailing Address - Phone:305-227-4020
Mailing Address - Fax:305-223-0355
Practice Address - Street 1:9100 CORAL WAY
Practice Address - Street 2:SUITE 2
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2076
Practice Address - Country:US
Practice Address - Phone:305-227-4020
Practice Address - Fax:305-223-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN110571223P0300X
FLDN118521223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty