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NPI Code Detail

MEDICARE: DR. CECILIA C. DIAZ D.D.S

MEDICARE:  DR. CECILIA C. DIAZ  D.D.S
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
11223G0001XGeneral Practice DentistryDN17363FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1203486602OTHERFLTAX PAYER ID NUMBER

General Provider Information

NPI Number : 1770526345
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CECILIA C. DIAZ D.D.S
Provider Business Mailing Address
First Line : 3714 W EUCLID AVE
Second Line :
City : TAMPA
State : FL
Zip : 33629-8725
Country : US
Telephone Number : 813-835-8900
Fax Number : 813-835-8614
Provider Business Practice Location Address
First Line : 3714 W EUCLID AVE
Second Line :
City : TAMPA
State : FL
Zip : 33629-8725
Country : US
Telephone Number : 813-835-8900
Fax Number : 813-835-8614
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 11/14/2007

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Directions to “ DR. CECILIA C. DIAZ D.D.S” Practice Location

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