Provider Demographics
NPI:1396542734
Name:DIAZ, PABLO FRACISCO
Entity type:Individual
Prefix:
First Name:PABLO
Middle Name:FRACISCO
Last Name:DIAZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 14TH ST NW APT 310
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-6850
Mailing Address - Country:US
Mailing Address - Phone:202-749-7077
Mailing Address - Fax:
Practice Address - Street 1:1475 COLUMBIA RD NW APT 406
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4784
Practice Address - Country:US
Practice Address - Phone:202-749-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant