Active NPI
Thelma Susette Diaz
- Student in an Organized Health Care Education/Training Program
- Miami, FL
National Provider Identifier
1295298842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 2999 NE 191St St
Miami, FL 33180-3123 - Phone
- (305) 682-1795
- NPI assigned
- Apr 10, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 26401 | FL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | PR | Primary |
Addresses
Primary practice location
2999 NE 191St St
Miami, FL 33180-3123
Mailing address
2999 NE 191St St
Miami, FL 33180-3123
Phone (305) 682-1795
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | florida |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26401 | FL | MD | Dentist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628985600000",
"number": "1295298842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2999 NE 191ST ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331803123",
"telephone_number": "305-682-1795",
"fax_number": "305-974-2661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2999 NE 191ST ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331803123",
"telephone_number": "305-682-1795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "THELMA",
"middle_name": "SUSETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-10",
"last_updated": "2021-08-15",
"certification_date": "2021-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "26401",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "florida",
"affiliation": "N",
"address_1": "2999 NE 191st St",
"city": "Miami",
"state": "FL",
"country_code": "US",
"postal_code": "331803123",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.