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General NPI Number Information
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NPI Number | 1699773192
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Entity Type | Organization
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Legal Business Name | DIAZ & DIAZ, INC
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 220 N MAIN ST
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City | TRENTON
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State | FL
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Zip | 32693-3438
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Country | US
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Telephone | 352-463-2240
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Fax | 352-463-1645
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Provider Business Mailing Address
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Address Line | 220 N MAIN ST
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City | TRENTON
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State | FL
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Zip | 32693-3438
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Country | US
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Telephone | 352-463-2240
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Fax | 352-463-1645
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LAWRENCE A DIAZ
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Credential | RPH
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Telephone | 352-463-2240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH8822
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License Number State | FL
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