| Diaz Medical Center, Inc. | |
|
303 Bryan Rd Suite 1 Brandon FL 33511-5342 | |
| (813) 684-6867 | |
| Not Available |
| Full Name | Diaz Medical Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 303 Bryan Rd, Brandon, Florida |
| Authorized Official Name and Position | Pamela Ruesch (ADMINISTRATOR) |
| Authorized Official Contact | 8133858089 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diaz Medical Center, Inc. 303 Bryan Rd Suite 1 Brandon FL 33511-5342 Ph: (813) 684-6867 | Diaz Medical Center, Inc. 303 Bryan Rd Suite 1 Brandon FL 33511-5342 Ph: (813) 684-6867 |
| NPI Number | 1053795815 |
|---|---|
| Provider Enumeration Date | 07/11/2015 |
| Last Update Date | 07/11/2015 |
| Medicare PECOS PAC ID | 2466762489 |
|---|---|
| Medicare Enrollment ID | O20151103002876 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053795815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Alejandro A Diaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336366624 PECOS PAC ID: 9234291519 Enrollment ID: I20081219000561 |
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