Active NPI
Agueda Perez-Diaz, D.M.D.
- General Practice Dentistry
- Hollywood, FL
National Provider Identifier
1598033540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN19248
- Practice address
- 11241 Rockinghorse Rd
Hollywood, FL 33026-1355 - Phone
- (954) 628-2410
- NPI assigned
- Dec 6, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN19248 | FL | Primary |
Addresses
Primary practice location
11241 Rockinghorse Rd
Hollywood, FL 33026-1355
Mailing address
11241 Rockinghorse Rd
Hollywood, FL 33026-1355
Phone (954) 628-2410
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 |
|---|---|---|---|
| DN19248 | FL | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323129600000",
"number": "1598033540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11241 ROCKINGHORSE RD",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330261355",
"telephone_number": "954-628-2410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11241 ROCKINGHORSE RD",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330261355",
"telephone_number": "954-628-2410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ-DIAZ",
"first_name": "AGUEDA",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-06",
"last_updated": "2011-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN19248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.