Provider Demographics
NPI:1023421294
Name:MACIAS, DIANA MARGARITA (ARNP)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:MARGARITA
Last Name:MACIAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 SW 13TH ST
Mailing Address - Street 2:#3204
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-4328
Mailing Address - Country:US
Mailing Address - Phone:754-214-2085
Mailing Address - Fax:
Practice Address - Street 1:60 SW 13TH ST
Practice Address - Street 2:#3204
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-4328
Practice Address - Country:US
Practice Address - Phone:754-214-2085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9276928163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse