Healthcare Provider Details

I. General information

NPI: 1336170034
Provider Name (Legal Business Name): CARLOS F. DIAZ-SILVEIRA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3661 S MIAMI AVE SUITE 903
MIAMI FL
33133-4236
US

IV. Provider business mailing address

3661 S MIAMI AVE SUITE 903
MIAMI FL
33133-4226
US

V. Phone/Fax

Practice location:
  • Phone: 305-854-0841
  • Fax:
Mailing address:
  • Phone: 305-854-0841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME0010650
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: