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General NPI Number Information
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NPI Number | 1295466571
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Entity Type | Individual
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Provider Name | SAUL ENMANUEL DIAZ-MARIN PMHNP-BC, FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/18/2022
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 2285 PEACHTREE RD NE FL 1
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City | ATLANTA
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State | GA
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Zip | 30309-1142
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Country | US
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Telephone | 470-460-5954
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Fax |
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Provider Business Mailing Address
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Address Line | 2030 MAIN ST NW APT 201
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City | ATLANTA
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State | GA
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Zip | 30318-1877
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Country | US
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Telephone | 786-470-9887
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP000820
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License Number State | GA
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