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General NPI Number Information
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NPI Number | 1972754935
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Entity Type | Individual
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Provider Name | ANGEL L DIAZ
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Gender | Male
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 10/08/2008
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Provider Practice Location Address
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Address Line | CARR 176 KM 11.2 CAM. RAMAL LOS GUAYABOS
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976
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Country | US
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Telephone | 787-310-3860
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Fax | 787-292-3912
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Provider Business Mailing Address
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Address Line | PO BOX 208
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City | TRUJILLO ALTO
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State | PR
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Zip | 00977-0208
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Country | US
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Telephone | 787-310-3860
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Fax | 787-292-3912
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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 | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | TC-AMB 345
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License Number State | PR
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