Healthcare Provider Details

I. General information

NPI: 1962859975
Provider Name (Legal Business Name): AMARILYS DIAZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2016
Last Update Date: 05/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 SW 82ND AVE
MIAMI FL
33155-2444
US

IV. Provider business mailing address

3110 SW 82ND AVE
MIAMI FL
33155-2444
US

V. Phone/Fax

Practice location:
  • Phone: 305-338-0824
  • Fax:
Mailing address:
  • Phone: 305-338-0824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberARNP9226531
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: