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General NPI Number Information
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NPI Number | 1538950753
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Entity Type | Organization
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Legal Business Name | DIAZ HEALTHCARE CENTER LLC
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 923 DEL PRADO BLVD S STE 103
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City | CAPE CORAL
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State | FL
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Zip | 33990-3627
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Country | US
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Telephone | 239-456-0196
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Fax | 239-456-0216
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Provider Business Mailing Address
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Address Line | 923 DEL PRADO BLVD S STE 103
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City | CAPE CORAL
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State | FL
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Zip | 33990-3627
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Country | US
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Telephone | 239-456-0196
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Fax | 239-456-0216
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Authorized Official
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Title or Position | M.D.
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Name | MANUEL DIAZ
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Credential | MD
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Telephone | 239-456-0196
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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 |
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License Number State |
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