Healthcare Provider Details

I. General information

NPI: 1861629461
Provider Name (Legal Business Name): CLAUDIO DIAZ-SOCARRAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 11/14/2020
Certification Date: 11/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S ANDREWS AVE
FORT LAUDERDALE FL
33316-2510
US

IV. Provider business mailing address

6705 RED RD SUITE 510
CORAL GABLES FL
33143
US

V. Phone/Fax

Practice location:
  • Phone: 954-355-5110
  • Fax:
Mailing address:
  • Phone: 888-624-3429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberME115492
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: