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NPI Code Detail

MEDICARE: JEANETTE DIAZ D.C

MEDICARE: JEANETTE DIAZ D.C
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
1111N00000XChiropractorCH9231FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861402646
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANETTE DIAZ D.C
Provider Business Mailing Address
First Line : PO BOX 430746
Second Line :
City : MIAMI
State : FL
Zip : 33243-0746
Country : US
Telephone Number : 786-380-6652
Fax Number :
Provider Business Practice Location Address
First Line : 1500 SW 27TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33145-2043
Country : US
Telephone Number : 305-448-1500
Fax Number : 305-448-8681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 03/25/2011

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Directions to “ JEANETTE DIAZ D.C” Practice Location

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