MEDICARE: LUIS ANGEL GARCIA DIAZ APRN

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	363LF0000X	Family Nurse Practitioner	11044349	FL

General Provider Information

NPI Number	:	1952266793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS ANGEL GARCIA DIAZ APRN

Provider Business Mailing Address
First Line	:	2150 W 68TH ST STE 200
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-1802
Country	:	US
Telephone Number	:	305-434-4546
Fax Number	:	305-250-5688

Provider Business Practice Location Address
First Line	:	2150 W 68TH ST STE 200
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-1802
Country	:	US
Telephone Number	:	305-434-4546
Fax Number	:	305-250-5688

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

Provider Enumeration Date	:	12/23/2025
Last Update Date	:	12/23/2025

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