| Organization Name: | SERVICIOS MEDICOS PROFESIONALES DOCTOR J. DIAZ CSP |
| NPI Number: | 1275693574 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMIL TARECK DIAZ (PRESIDENT) |
| Mailing Address: | Centro Coop Carr 115 Bo. Asomante Suite 2 Aguada |
| State: | PR US |
| Postal Code: | 006020953 |
| Phone Number: | 7878681599 |
| Fax Number: | 7878680045 |
| NPI Enumeration Date: | 12/10/2006 |
| NPI Last Update Date: | 09/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 12986 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |