Healthcare Provider Details

I. General information

NPI: 1306809512
Provider Name (Legal Business Name): ROBERTO J DIAZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ADVENTHEALTH MEDICAL GROUP GASTROENTEROLOGY & HEPATOLOG 4325 SUN N. LAKE BLVD
SEBRING FL
33872
US

IV. Provider business mailing address

4325 SUN N LAKE BLVD
SEBRING FL
33872
US

V. Phone/Fax

Practice location:
  • Phone: 863-402-3310
  • Fax: 863-664-7710
Mailing address:
  • Phone: 863-402-3310
  • Fax: 863-664-7710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME0071926
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: