Healthcare Provider Details

I. General information

NPI: 1194477760
Provider Name (Legal Business Name): DARLENE DURAN DIAZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12105 SW 214TH TER
MIAMI FL
33177-5948
US

IV. Provider business mailing address

12105 SW 214TH TER
MIAMI FL
33177-5948
US

V. Phone/Fax

Practice location:
  • Phone: 786-280-7735
  • Fax:
Mailing address:
  • Phone: 786-280-7735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF07260051
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number21-757
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: