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General NPI Number Information
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NPI Number | 1780489765
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Entity Type | Organization
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Legal Business Name | JOHN RUFO DIAZ MD
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 5470 BRYSON CT
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City | NAPLES
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State | FL
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Zip | 34109-6000
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Country | US
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Telephone | 239-451-9747
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Fax |
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Provider Business Mailing Address
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Address Line | 166 WICKLIFFE DR
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City | NAPLES
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State | FL
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Zip | 34110-1334
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Country | US
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Telephone | 239-877-8522
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Fax |
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Authorized Official
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Title or Position | OWNER/MD
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Name | DR. JOHN R DIAZ
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Credential | MD
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Telephone | 239-877-8522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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