Provider Demographics
NPI:1790176311
Name:ZULETA, DIANA (DO)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:ZULETA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:160 S FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1720
Mailing Address - Country:US
Mailing Address - Phone:954-620-0011
Mailing Address - Fax:954-620-0238
Practice Address - Street 1:160 S FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1720
Practice Address - Country:US
Practice Address - Phone:954-620-0011
Practice Address - Fax:954-620-0238
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS15382207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine