Active NPI
Jose Raul Garriga-Diaz I, M.D.
- General Practice Physician
- Lake City, FL
National Provider Identifier
1407062391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- ACN140
- Practice address
- 7906 E US Highway 90
Lake City, FL 32055-6290 - Phone
- (386) 755-3379
- Fax
- (386) 752-2242
- NPI assigned
- May 15, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 011873 | PR | |
| General Practice Physician | 208D00000X | ACN140 | FL | Primary |
Addresses
Primary practice location
7906 E US Highway 90
Lake City, FL 32055-6290
Mailing address
4014 NW Colonial GLN
Lake City, FL 32055-4856
Phone (386) 754-0156
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACN140 | FL | MD | General Practice Physician |
| 011873 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407062391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4014 NW COLONIAL GLN",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320554856",
"telephone_number": "386-754-0156",
"fax_number": "386-752-2242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7906 E US HIGHWAY 90",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320556290",
"telephone_number": "386-755-3379",
"fax_number": "386-752-2242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARRIGA-DIAZ",
"first_name": "JOSE",
"middle_name": "RAUL",
"name_prefix": "Dr.",
"name_suffix": "I",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "011873",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "ACN140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.