Provider Demographics
NPI:1427767813
Name:DIAZ BARRETO, XIOMARA (MD)
Entity type:Individual
Prefix:
First Name:XIOMARA
Middle Name:
Last Name:DIAZ BARRETO
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:PO BOX 4055
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4055
Mailing Address - Country:US
Mailing Address - Phone:787-658-0000
Mailing Address - Fax:787-819-0805
Practice Address - Street 1:CARR #2 KM 127.4 EDIF PUNTO ORO SUITE 9
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-658-7098
Practice Address - Fax:866-400-3604
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-15
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24058208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice