Provider Demographics
NPI:1013453810
Name:DIAZ ACEVEDO, EMILY (MSN, ARNP-FNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:DIAZ ACEVEDO
Suffix:
Gender:F
Credentials:MSN, ARNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7437 SW 162ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-4414
Mailing Address - Country:US
Mailing Address - Phone:786-657-6412
Mailing Address - Fax:
Practice Address - Street 1:7437 SW 162ND CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-4414
Practice Address - Country:US
Practice Address - Phone:786-657-6412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9316793363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily