MEDICARE: MARILIZ AMARO DIAZ

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	183500000X	Pharmacist	PSI61492	FL

General Provider Information

NPI Number	:	1134727647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILIZ AMARO DIAZ

Provider Business Mailing Address
First Line	:	7900 PASADENA BLVD
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-3579
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3395 W 68TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-1728
Country	:	US
Telephone Number	:	305-825-5226
Fax Number	:

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

Provider Enumeration Date	:	10/16/2020
Last Update Date	:	10/16/2020

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Directions to “ MARILIZ AMARO DIAZ ” Practice Location

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