MEDICARE: JORGE ANDRES 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	207R00000X	Internal Medicine Physician	ME175793	FL
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1659073930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE ANDRES DIAZ MD

Provider Business Mailing Address
First Line	:	11750 SW 40TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-3530
Country	:	US
Telephone Number	:	305-485-4677
Fax Number	:

Provider Business Practice Location Address
First Line	:	11750 SW 40TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-3530
Country	:	US
Telephone Number	:	305-485-4677
Fax Number	:

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

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	12/11/2025

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