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Dr. Enrique Diaz

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NPI Number Detailed Information

Provider Information:

Name: Dr. Enrique Diaz
Gender: M
Provider License Number If Given: 681

NPI Information:

NPI: 1215936752
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: PO BOX 293 #6 ST D-35 SYLVIA
Corozal, PR 00783
Phone Number: 7878592731
Fax Number:

Provider Business Practice Location Address:

Address: 5A CALLE CERVANTES
Corozal, PR 00783
Phone Number: 7878592731
Fax Number:

Provider Taxonomy:

Primary: 122300000X
Secondary (if any):
State: PR