| Doctor Name: | DR. OMAR E DIAZ SOJO |
| NPI Number: | 1104802065 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 16148 |
| Business Practice Address: | Pq28 Ave El Comandante Carolina, PR - 009822777 |
| Business Phone Number: | 7877696548 |
| Business Fax Number: | 7877696565 |
| Mailing Address: | 369 Calle Citadel, Reparto Universitario SAN JUAN |
| State: | PR |
| Postal Code: | 009261824 |
| Phone Number: | 7876132525 |
| Fax Number: | |
| NPI Enumeration Date: | 12/21/2005 |
| NPI Last Update Date: | 12/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 16148 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |