Provider Demographics
NPI:1740662303
Name:DIAZ, NURYS (RN)
Entity type:Individual
Prefix:
First Name:NURYS
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 SW 116TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-4665
Mailing Address - Country:US
Mailing Address - Phone:786-354-0278
Mailing Address - Fax:
Practice Address - Street 1:4210 SW 116TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-4665
Practice Address - Country:US
Practice Address - Phone:786-354-0278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9404977163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL$$$$$$$$$Medicare PIN