Healthcare Provider Details

I. General information

NPI: 1609011295
Provider Name (Legal Business Name): PACO M DIAZ-PARES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2008
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PR 129 KM 1.0 AVE SAN LUIS
ARECIBO PR
00613
US

IV. Provider business mailing address

SABANERA DE DORADO 613 CAMINO DE CARRAIZO
DORADO PR
00646
US

V. Phone/Fax

Practice location:
  • Phone: 787-650-7272
  • Fax: 787-650-7248
Mailing address:
  • Phone: 787-650-7272
  • Fax: 787-650-7248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number18236
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number27229
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: