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General NPI Number Information
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NPI Number | 1659330900
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Entity Type | Individual
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Provider Name | RODRIGO DIAZ MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 05/17/2011
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Provider Practice Location Address
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Address Line | AVE FD ROOSEVET 400 SUITE 304
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City | HATO REY
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-753-7406
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Fax | 787-753-0054
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Provider Business Mailing Address
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Address Line | 400 AVE FD ROOSEVELT SUITE 304
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City | SAN JUAN
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State | PR
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Zip | 00918-2130
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Country | US
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Telephone | 787-753-7406
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Fax | 787-753-0054
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 11301
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License Number State | PR
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