Manuel Diez, M.D., P.a.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME27360 Issued in FL

Legal business name

MANUEL DIEZ, M.D., P.A.

Practice address

800 E Broward Blvd Ste 608
Ft Lauderdale, FL 33301-2029

Phone

(954) 462-8030

Fax

(954) 462-8090

NPI assigned

Apr 25, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Manuel J Diez Lopez, MD

Title

President

Phone

(954) 462-8030

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518186469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E BROWARD BLVD STE 608",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012029",
            "telephone_number": "954-462-8030",
            "fax_number": "954-462-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E BROWARD BLVD STE 608",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012029",
            "telephone_number": "954-462-8030",
            "fax_number": "954-462-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUEL DIEZ, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIEZ LOPEZ",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-462-8030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME27360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1588767115",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Ft Lauderdale, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.