| Neisa I. Diaz, M.D., L.L.C. | |
|
13501 Icot Blvd Suite 114 Clearwater FL 33760-3729 | |
| (727) 754-7880 | |
| (727) 754-7885 |
| Full Name | Neisa I. Diaz, M.D., L.L.C. |
|---|---|
| Speciality | Internal Medicine |
| Location | 13501 Icot Blvd, Clearwater, Florida |
| Authorized Official Name and Position | Neisa I Diaz (OWNER) |
| Authorized Official Contact | 7277547880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neisa I. Diaz, M.D., L.L.C. 13501 Icot Blvd Suite 114 Clearwater FL 33760-3729 Ph: (727) 754-7880 | Neisa I. Diaz, M.D., L.L.C. 13501 Icot Blvd Suite 114 Clearwater FL 33760-3729 Ph: (727) 754-7880 |
| NPI Number | 1659713261 |
|---|---|
| Provider Enumeration Date | 07/24/2013 |
| Last Update Date | 07/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659713261 | NPI | - | NPPES |
| 277721500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 97050 (Florida) | Primary |
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