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General NPI Number Information
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NPI Number | 1821208117
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Entity Type | Organization
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Legal Business Name | HUGO DIEZ JR MD PA
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/07/2020
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Provider Practice Location Address
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Address Line | 11880 SW 40TH ST SUITE 216
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City | MIAMI
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State | FL
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Zip | 33175-3584
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Country | US
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Telephone | 305-552-5792
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Fax | 305-552-6119
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Provider Business Mailing Address
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Address Line | 11880 SW 40TH ST SUITE 216
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City | MIAMI
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State | FL
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Zip | 33175-3584
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Country | US
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Telephone | 305-552-5792
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Fax | 305-552-6119
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | DR. HUGO DIEZ JR JR.
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Credential | MD
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Telephone | 305-552-5792
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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 | ME0059913
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License Number State | FL
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