Doctor Name: | DR. WILMER RODRIGUEZ DIAZ |
NPI Number: | 1154567493 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 17426 |
Business Practice Address: | Hc 5 Box 11285 Corozal, PR - 007839593 |
Business Phone Number: | 7876744850 |
Business Fax Number: | |
Mailing Address: | Hc 5 Box 11285, COROZAL |
State: | PR |
Postal Code: | 007839593 |
Phone Number: | 7876744850 |
Fax Number: | |
NPI Enumeration Date: | 12/16/2008 |
NPI Last Update Date: | 12/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 17426 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |