Provider Demographics
NPI:1750342689
Name:DIAZ, LESLIE ERLINDA (MD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ERLINDA
Last Name:DIAZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:840 US HWY ONE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3832
Mailing Address - Country:US
Mailing Address - Phone:561-776-8300
Mailing Address - Fax:561-776-0727
Practice Address - Street 1:840 US HWY ONE
Practice Address - Street 2:SUITE 120
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3832
Practice Address - Country:US
Practice Address - Phone:561-776-8300
Practice Address - Fax:561-776-0727
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64006207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250128700Medicaid
FL250128700Medicaid
G37103Medicare UPIN