Healthcare Provider Details

I. General information

NPI: 1336179985
Provider Name (Legal Business Name): ROLANDO ELIO DIAZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W 49TH ST STE 448
HIALEAH FL
33012-3487
US

IV. Provider business mailing address

900 W 49TH ST STE 448
HIALEAH FL
33012-3487
US

V. Phone/Fax

Practice location:
  • Phone: 305-560-5446
  • Fax: 786-353-9801
Mailing address:
  • Phone: 305-560-5446
  • Fax: 786-353-9801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15857
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME95472
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: