Healthcare Provider Details

I. General information

NPI: 1386876639
Provider Name (Legal Business Name): LINDSEY CHRISTINA DIAZ P.A.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SAINT MICHAELS DR
SANTA FE NM
87505-7601
US

IV. Provider business mailing address

PO BOX 551420
FORT LAUDERDALE FL
33355-1420
US

V. Phone/Fax

Practice location:
  • Phone: 505-913-4919
  • Fax:
Mailing address:
  • Phone: 800-243-3839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License NumberAA2021-002
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: