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General NPI Number Information
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NPI Number | 1174218184
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Entity Type | Individual
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Provider Name | BENJAMIN ARTURO DIAZ DUARTE CRNA
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Gender | Male
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Dates
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Enumeration Date | 04/06/2023
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 365 MONTAUK AVE
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City | NEW LONDON
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State | CT
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Zip | 06320-4700
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Country | US
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Telephone | 801-903-9532
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Fax |
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Provider Business Mailing Address
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Address Line | 602 GOLDEN SUNSHINE CIR
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City | ORLANDO
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State | FL
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Zip | 32807-3456
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Country | US
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Telephone | 801-903-9532
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 210889
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 9464145
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 11027334
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0024189711
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 12188
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License Number State | CT
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