Provider Demographics
NPI:1124548763
Name:DIAZ-PAEZ, LUIS RUBEN (ARNP)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:RUBEN
Last Name:DIAZ-PAEZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10861 SW 128TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-5442
Mailing Address - Country:US
Mailing Address - Phone:786-763-9917
Mailing Address - Fax:
Practice Address - Street 1:9333 SW 152 ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157
Practice Address - Country:US
Practice Address - Phone:305-251-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9410772363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily