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NPI Code Detail

MEDICARE: LIEGE ISABEL DIAZ URRUTIA M.D.

MEDICARE: LIEGE ISABEL DIAZ URRUTIA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program18682FL
2207RG0100XGastroenterology PhysicianME161493FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023456043
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIEGE ISABEL DIAZ URRUTIA M.D.
Provider Business Mailing Address
First Line : 9200 S DADELAND BLVD STE 800
Second Line :
City : MIAMI
State : FL
Zip : 33156-2758
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3001 CORAL HILLS DR STE 250
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33065-4175
Country : US
Telephone Number : 954-721-5400
Fax Number : 877-840-6994
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2013
Last Update Date : 06/03/2026

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