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General NPI Number Information
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NPI Number | 1871486787
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Entity Type | Individual
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Provider Name | YASMARY DIAZ OD
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Gender | Female
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 3700 W 18TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-7028
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Country | US
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Telephone | 305-459-7900
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Fax | 645-999-1359
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Provider Business Mailing Address
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Address Line | 970 W 66TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-6470
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Country | US
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Telephone | 305-761-6411
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Fax | 645-999-1359
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC6700
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License Number State | FL
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