MEDICARE: DR. LUIS MIGUEL DIAZ M.D.

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	8248	PR
2	208D00000X	General Practice Physician	8248	PR

General Provider Information

NPI Number	:	1821134297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS MIGUEL DIAZ M.D.

Provider Business Mailing Address
First Line	:	158 CALLE SAN FELIPE
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00612
Country	:	US
Telephone Number	:	787-879-3995
Fax Number	:	787-879-3995

Provider Business Practice Location Address
First Line	:	175 CALLE SAN FELIPE
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00612-4605
Country	:	US
Telephone Number	:	787-879-3995
Fax Number	:	787-650-1385

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/16/2024

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