Active NPI
Danielle Nikole Diaz, PA-C
- Physician Assistant
- Miami, FL
National Provider Identifier
1780279869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9118555
- Practice address
- 9922 SW 21St St
Miami, FL 33165-7506 - Phone
- (305) 799-3082
- NPI assigned
- Mar 1, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 9118555 | FL | Primary |
Addresses
Primary practice location
9922 SW 21St St
Miami, FL 33165-7506
Mailing address
9922 SW 21St St
Miami, FL 33165-7506
Phone (305) 799-3082
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 5, 2024 through Jun 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9118555 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717632000000",
"number": "1780279869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9922 SW 21ST ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331657506",
"telephone_number": "305-799-3082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9922 SW 21ST ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331657506",
"telephone_number": "305-799-3082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "DANIELLE",
"middle_name": "NIKOLE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-01",
"last_updated": "2024-06-06",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9118555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.