Healthcare Provider Details

I. General information

NPI: 1154244812
Provider Name (Legal Business Name): KITMING ANDRES DIAZ SILVA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W OAKLAND PARK BLVD
OAKLAND PARK FL
33311-1520
US

IV. Provider business mailing address

5050 NW 7TH ST APT 306
MIAMI FL
33126-3452
US

V. Phone/Fax

Practice location:
  • Phone: 754-200-8248
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11049946
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: