Healthcare Provider Details

I. General information

NPI: 1487706982
Provider Name (Legal Business Name): SILVIO DIAZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 03/12/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 COLLINS AVE APT 902
MIAMI BEACH FL
33140
US

IV. Provider business mailing address

2555 COLLINS AVE. APT 902
MIAMI BEACH FL
33140
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-4380
  • Fax: 305-538-7713
Mailing address:
  • Phone: 305-642-4380
  • Fax: 305-538-7713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME0041648
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: