Healthcare Provider Details

I. General information

NPI: 1326229733
Provider Name (Legal Business Name): ENRIQUE DIAZ GUZMAN ZAVALA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 COLLIER RD NW STE 3000
ATLANTA GA
30309-1721
US

IV. Provider business mailing address

4200 HOUMA BLVD
METAIRIE LA
70006-2970
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-5140
  • Fax:
Mailing address:
  • Phone: 504-988-3541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number126944
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number126944
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number346674
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number112255
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number57.007160
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number126944
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number31970
License Number StateAL
# 8
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number42818
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: