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General NPI Number Information
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NPI Number | 1033274014
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Entity Type | Organization
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Legal Business Name | EDUARDO DIAZ, MD PA
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 5703 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33126-3105
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Country | US
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Telephone | 305-267-3462
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Fax | 305-267-3463
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Provider Business Mailing Address
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Address Line | 14520 SW 9TH ST
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City | MIAMI
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State | FL
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Zip | 33184-3118
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Country | US
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Telephone | 305-485-9986
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Fax | 305-267-3463
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDUARDO DIAZ
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Credential | M.D.
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Telephone | 305-267-3462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME88639
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License Number State | FL
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