Individual provider · NPI-1

Jose M Diaz, M.D

General Practice · Tampa, FL

NPI number1497792162
StatusActive
Last updated in NPPESNov 12, 2019

Details

NPI
1497792162
Entity type
Individual (NPI-1)
Name
Jose M Diaz
Credential
M.D
Sex
Male
Sole proprietor
No
Enumeration date
Jun 1, 2006
Last updated
Nov 12, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208D00000X General PracticeME122262FLYes
207ZP0101X Pathology, Anatomic Pathology8643PR
207U00000X Nuclear Medicine8643PR
2085U0001X Radiology, Diagnostic Ultrasound8643PR

Practice location

6904 W Linebaugh Ave
Tampa, FL 33625-5800

Phone 813-888-7710

Mailing address

2347 Tioga Dr
Land O Lakes, FL 34639-5420

Other practice locations

4912 N Armenia Ave
Tampa, FL 33603-1402

Phone 813-871-2950

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