Provider Demographics
NPI:1144439951
Name:DIAZ, ESMERALDA (PHARM D)
Entity type:Individual
Prefix:MS
First Name:ESMERALDA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5575 SW 77TH CT
Mailing Address - Street 2:APT 106B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4398
Mailing Address - Country:US
Mailing Address - Phone:305-279-1386
Mailing Address - Fax:
Practice Address - Street 1:5575 SW 77TH CT
Practice Address - Street 2:APT 106B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4398
Practice Address - Country:US
Practice Address - Phone:305-279-1386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist