MEDICARE: YOHAN DIAZ ZUNIGA

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	163W00000X	Registered Nurse	RN9652617	FL
2	163W00000X	Registered Nurse	926562	NY
3	363LF0000X	Family Nurse Practitioner	APRN11046046	FL

General Provider Information

NPI Number	:	1730998063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOHAN DIAZ ZUNIGA

Provider Business Mailing Address
First Line	:	206 DOVER BLUFF DR
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-7691
Country	:	US
Telephone Number	:	502-403-3199
Fax Number	:

Provider Business Practice Location Address
First Line	:	653 W 8TH ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-6511
Country	:	US
Telephone Number	:	904-480-8244
Fax Number	:

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

Provider Enumeration Date	:	01/02/2025
Last Update Date	:	03/12/2026

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