Provider Demographics
NPI:1295466571
Name:DIAZ-MARIN, SAUL ENMANUEL (PMHNP-BC, FNP-BC)
Entity type:Individual
Prefix:MR
First Name:SAUL
Middle Name:ENMANUEL
Last Name:DIAZ-MARIN
Suffix:
Gender:
Credentials:PMHNP-BC, FNP-BC
Other - Prefix:MR
Other - First Name:SAUL
Other - Middle Name:ENMANUEL
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PMHNP-BC, FNP-BC
Mailing Address - Street 1:2030 MAIN ST NW APT 201
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-1877
Mailing Address - Country:US
Mailing Address - Phone:786-470-9887
Mailing Address - Fax:
Practice Address - Street 1:2285 PEACHTREE RD NE FL 1
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1142
Practice Address - Country:US
Practice Address - Phone:470-460-5954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-18
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GANP000820363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily