MEDICARE: OSMANI DIAZ DDS PA

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
1	1223G0001X	General Practice Dentistry	DN12310	FL

General Provider Information

NPI Number	:	1205185410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSMANI DIAZ DDS PA

Provider Business Mailing Address
First Line	:	650 NW 180TH TER STE 103
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-2825
Country	:	US
Telephone Number	:	954-437-9288
Fax Number	:	954-437-7929

Provider Business Practice Location Address
First Line	:	650 NW 180TH TER STE 103
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-2825
Country	:	US
Telephone Number	:	954-437-9288
Fax Number	:	954-437-7929

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. JOSEFINA DIAZ
Credential	:
Telephone Number	:	954-437-9288

Provider Enumeration Date	:	09/04/2012
Last Update Date	:	09/04/2012

Similar Medicare Providers

1639175623 — DR. OSMANI DIAZ D.D.S.
Practice Location Address:

650 NW 180TH TER , STE 103
PEMBROKE PINES, FL
33029-2825

Practice Phone: 954-437-9288
Practice Fax: 954-437-7929

1497810949 — DR. JORGE L SERRAT M.D.
Practice Location Address:

650 NW 180TH TER , SUITE 101
PEMBROKE PINES, FL
33029-2825

Practice Phone: 954-392-1880
Practice Fax: 954-392-1088

1861643967 — DR. ROBERT MICHAEL WAGNER JR. D.M.D.
Practice Location Address:

650 NW 180TH TER , SUITE 103
PEMBROKE PINES, FL
33029-2825

Practice Phone: 954-437-9288
Practice Fax: 954-437-7929

1295968048 — DR. ERNESTO PADRON M.D
Practice Location Address:

650 NW 180TH TER STE 102
PEMBROKE PINES, FL
33029-2825

Practice Phone: 954-436-1212
Practice Fax:

1629340682 — SYNERGIE HOLISTIC MEDICINE, INC.
Practice Location Address:

650 NW 180TH TER , SUITE 101
PEMBROKE PINES, FL
33029-2825

Practice Phone: 954-435-4900
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1245695931 — JORGE L SERRAT
Practice Location Address:

650 NW 180TH TER , SUITE 101
PEMBROKE PINES, FL
33029-2825

Practice Phone: 954-392-1880
Practice Fax: 954-392-1088

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