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General NPI Number Information
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NPI Number | 1629159645
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Entity Type | Individual
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Provider Name | LUIS M. DIAZ BARRIOS MD.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | AVE. GENERAL VALERO #303 SUITE 102
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City | FAJARDO
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State | PR
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Zip | 00738
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Country | US
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Telephone | 787-860-0005
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Fax | 787-860-0676
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Provider Business Mailing Address
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Address Line | PO BOX 30035
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City | SAN JUAN
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State | PR
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Zip | 00929-1035
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Country | US
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Telephone | 787-860-0005
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Fax | 787-860-0676
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 8546
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License Number State | PR
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