Provider Demographics
NPI:1477301653
Name:DE LA PAZ, ADRIEL
Entity type:Individual
Prefix:
First Name:ADRIEL
Middle Name:
Last Name:DE LA PAZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 NW 77TH AVE # W403
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-2851
Mailing Address - Country:US
Mailing Address - Phone:786-222-5041
Mailing Address - Fax:949-864-3585
Practice Address - Street 1:5901 SW 74TH ST STE 408
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5164
Practice Address - Country:US
Practice Address - Phone:305-735-3555
Practice Address - Fax:954-990-7650
Is Sole Proprietor?:No
Enumeration Date:2024-05-11
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11032742363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health