Provider Demographics
NPI:1366530842
Name:DIAZ, SOLIMAR (MD)
Entity type:Individual
Prefix:DR
First Name:SOLIMAR
Middle Name:
Last Name:DIAZ
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 1:11 ST. S.E. #1036 REPARTO METROPOLITANO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-3121
Mailing Address - Country:US
Mailing Address - Phone:787-767-4804
Mailing Address - Fax:787-767-4804
Practice Address - Street 1:11 ST. S.E. #1036 REPARTO METROPOLITANO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3121
Practice Address - Country:US
Practice Address - Phone:787-767-4804
Practice Address - Fax:787-767-4804
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16555208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice