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General NPI Number Information
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NPI Number | 1184039612
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Entity Type | Individual
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Provider Name | ORLANDO ARTAVIA DINIZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 405 W COUNTRY CLUB RD
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City | ROSWELL
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State | NM
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Zip | 88201-5209
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Country | US
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Telephone | 575-627-4077
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Fax | 575-624-5607
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Provider Business Mailing Address
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Address Line | PO BOX 708760
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City | SANDY
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State | UT
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Zip | 84070-8760
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Country | US
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Telephone | 801-352-9500
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Fax | 801-352-7976
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD2017-0233
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | U2147
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | U2147
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License Number State | TX
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