MEDICARE: GEORGE C DIAZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	ME0066992	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	238332	OTHER	FL	AVMED
2	26252	OTHER	FL	BLUE CROSS BLUE SHIELD
3	400000450000	OTHER	FL	PREFERRED CARE PARTNERS
4	NNC106	OTHER	FL	WELLCARE/STAYWELL
5	30573	OTHER	FL	NHP
6	4243290	OTHER	FL	AETNA LIFE INS CO
7	7911330	OTHER	FL	GHI
8	3000011	OTHER	FL	CIGNA
9	F91226	OTHER	FL	VISTA
10	1024133	OTHER	FL	CARE PLUS
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083611677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE C DIAZ MD

Provider Business Mailing Address
First Line	:	2900 CORPORATE WAY
Second Line	:	DOOR D
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3925
Country	:	US
Telephone Number	:	954-276-5685
Fax Number	:	954-985-7074

Provider Business Practice Location Address
First Line	:	2063 BISCAYNE BLVD FL 5
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33137
Country	:	US
Telephone Number	:	305-682-2900
Fax Number	:	786-753-6131

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	04/14/2023

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Directions to “ GEORGE C DIAZ MD” Practice Location

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