Provider Demographics
NPI:1154539740
Name:DIAZ-GARCIA, RAFAEL J (MD)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:J
Last Name:DIAZ-GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100905
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0905
Mailing Address - Country:US
Mailing Address - Phone:786-596-8040
Mailing Address - Fax:
Practice Address - Street 1:8940 N KENDALL DR STE 602E
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2177
Practice Address - Country:US
Practice Address - Phone:786-596-8040
Practice Address - Fax:412-359-8285
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162566207XS0106X
PAMD4476792082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102958351Medicaid
367981Medicare PIN