Healthcare Provider Details

I. General information

NPI: 1902721608
Provider Name (Legal Business Name): LUZ M DIAZ PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3341 EXECUTIVE WAY
MIRAMAR FL
33025-3935
US

IV. Provider business mailing address

6264 SARATOGA CIR
DAVIE FL
33331-2104
US

V. Phone/Fax

Practice location:
  • Phone: 954-417-6454
  • Fax:
Mailing address:
  • Phone: 954-812-8380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS20936
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: