National Provider Identifier Database

JESUS E DIAZ
Laboratory Management


Contact Information

JESUS E DIAZ
1150 45TH ST
ROOM L-200
WEST PALM BEACH, FL33407-2361
Phone: 561-514-5360
Fax: 561-514-5550
Website:
Specialty Taxonomy Code
* Laboratory Management 246QL0900X

* Indicates primary specialty

NPI Profile & details for JESUS E DIAZ

NPI Number 1497122022
Credentials
Entity Individual
Enumeration date 08/31/2015
Last updated 08/31/2015 - About 11 years ago
Sole proprietor1 No
Identifiers
  • FL License #: SU28604
  • FL Medicaid: 030448400
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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