Healthcare Provider Details

I. General information

NPI: 1184278400
Provider Name (Legal Business Name): GABRIEL ESTEBAN DIAZ-PAGAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21097 NE 27TH CT STE 540
AVENTURA FL
33180-1235
US

IV. Provider business mailing address

21097 NE 27TH CT STE 540
AVENTURA FL
33180-1235
US

V. Phone/Fax

Practice location:
  • Phone: 305-914-3480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number175816
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: