Provider Demographics
NPI:1285659896
Name:DIEZ, ELSIE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ELSIE
Middle Name:MARIE
Last Name:DIEZ
Suffix:
Gender:F
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:VILLAS PASEO SOL #32,
Mailing Address - Street 2:URB. LOS PASEOS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-293-6141
Mailing Address - Fax:787-292-3286
Practice Address - Street 1:VILLAS PASEO SOL #32,
Practice Address - Street 2:URB. LOS PASEOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-293-6141
Practice Address - Fax:787-292-3286
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13217207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology