Healthcare Provider Details

I. General information

NPI: 1750852307
Provider Name (Legal Business Name): ELIZABETH DIAZ AGUERO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2018
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13791 SW 66TH ST APT E271
MIAMI FL
33183-1883
US

IV. Provider business mailing address

7905 SW 13TH ST
MIAMI FL
33144-4331
US

V. Phone/Fax

Practice location:
  • Phone: 786-367-1162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11000963
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9324572
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: