Provider Demographics
NPI:1487706982
Name:DIAZ, SILVIO (MD)
Entity type:Individual
Prefix:MR
First Name:SILVIO
Middle Name:
Last Name:DIAZ
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 1:2555 COLLINS AVE.
Mailing Address - Street 2:APT 902
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140
Mailing Address - Country:US
Mailing Address - Phone:305-642-4380
Mailing Address - Fax:305-538-7713
Practice Address - Street 1:2555 COLLINS AVE
Practice Address - Street 2:APT 902
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140
Practice Address - Country:US
Practice Address - Phone:305-642-4380
Practice Address - Fax:305-538-7713
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0041648208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067729900Medicaid
96263Medicare ID - Type Unspecified
D63797Medicare UPIN