Healthcare Provider Details
I. General information
NPI: 1154539740
Provider Name (Legal Business Name): RAFAEL J DIAZ-GARCIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/18/2007
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8940 N KENDALL DR STE 602E
MIAMI FL
33176-2177
US
IV. Provider business mailing address
PO BOX 100905
ATLANTA GA
30384-0905
US
V. Phone/Fax
- Phone: 786-596-8040
- Fax: 412-359-8285
- Phone: 786-596-8040
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | ME162566 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: