Healthcare Provider Details

I. General information

NPI: 1538532130
Provider Name (Legal Business Name): NEOVES DIAZ ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: NEOVES DIAZ-FROMETA

II. Dates (important events)

Enumeration Date: 11/04/2015
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE
MIAMI FL
33136-1005
US

IV. Provider business mailing address

PO BOX 12493
MIAMI FL
33101-2493
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-1111
  • Fax: 305-585-6557
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9224255
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: