Look up the most recent NPI and PECOS records

Jorge B Diaz

General Practice

Allopathic & Osteopathic Physicians

8011 N Himes Ave Ste 4, Tampa, FL 33614-2700

PECOS Enrollment

This provider is enrolled in PECOS as JORGE DIAZ.

Based on the most recent information from CMS, provider Jorge B Diaz is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1699157180
Provider Type
Individual
Full Name
Diaz, Jorge B
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
6/22/2015
Last Updated
3/28/2019

Contact Information

Practice Location

8011 N Himes Ave Ste 4, Tampa, FL 33614-2700

(813) 488-1414

(813) 488-1413

Mailing Location

8011 N Himes Ave Ste 4, Tampa, FL 33614-2700

(813) 488-1414

(813) 488-1413

Provider Taxonomies

Code	Description	License
Code 208D00000X Primary	Description General Practice Allopathic & Osteopathic Physicians	License ACN671 Florida

Provider Identifiers

ID	Description	Issuer
ID ACN671	Description Other	Issuer MEDICAL LICENSE Florida

Jorge B Diaz

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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