Marvin Diaz-Lacayo, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0022072 Issued in FL

Practice address

21150 Biscayne Blvd
Ste 101
Aventura, FL 33180-1226

Phone

(305) 932-4198

Fax

(305) 932-9102

NPI assigned

May 23, 2005

Reactivated

Mar 21, 2006

Last updated

Dec 28, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198800000000",
    "number": "1871596098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21150 BISCAYNE BLVD",
            "address_2": "STE 101",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801226",
            "telephone_number": "305-932-4198",
            "fax_number": "305-932-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21150 BISCAYNE BLVD",
            "address_2": "STE 101",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801226",
            "telephone_number": "305-932-4198",
            "fax_number": "305-932-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ-LACAYO",
        "first_name": "MARVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2007-12-28",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0022072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DG Services Professional
• Sindy S Dharampaul, DOCTOR OF PHARMACY
• Diagnostic Portable Lab
• Helen Dias Ferreira
• Alejandro Diaz Tejeda, DMD
• Gabriel Esteban Diaz-Pagan
• Alejandro Diaz, DPT
• Ashley Rosemary Diaz, MD
• Bryan Diaz
• Raiko Diaz, D.O.

• Specialist in Aventura, FL
• Providers in Aventura, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.