MEDICARE: SARA ELIZABETH DIAZ DE ARCE PA-C

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	363A00000X	Physician Assistant	PA9112362	FL
2	363A00000X	Physician Assistant	085010522	IL
3	363A00000X	Physician Assistant	MA060004	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104312024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA ELIZABETH DIAZ DE ARCE PA-C

Provider Business Mailing Address
First Line	:	8900 N KENDALL DR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-2118
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 W HARRISON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-3106
Country	:	US
Telephone Number	:	800-226-2371
Fax Number	:

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

Provider Enumeration Date	:	07/03/2018
Last Update Date	:	12/08/2025

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