GUSTAVO ADOLFO DIAZ (NPI# 1164599825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164599825 |
| Entity Type | Individual |
| Full Name | GUSTAVO ADOLFO DIAZ |
| Credential | M.D. |
| Practice Address |
411 N Section St Ste 5 Fairhope AL 36532-2650 |
| Mailing Address |
17026 Carlton Way Rd Huntersville NC 28078 |
| Practice Telephone | 2515175050 |
| Practice Fax Number | 2515175049 |
| Mailing Telephone | 2517532209 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2019-08-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
25353 | AL | Allopathic & Osteopathic Physicians |
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
02055 | NC | Allopathic & Osteopathic Physicians |
| N | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
ME103280 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588147193 | Gustavo Diaz Jr. | Nurse Practitioner | 6050 W 20th Ave, Hialeah, FL 33016-2605 | 2018-09-10 |
| 1538122635 | Gustavo A. Diaz | Emergency Medicine | 1513 Fremont Blvd, E1, Seaside, CA 93955-4319 | 2006-04-10 |
| 1730123977 | Gustavo A Diaz | Physician Assistant | 911 E. 20th St., Ste. 300, Sioux Falls, SD 57105-1045 | 2006-06-16 |
| Street Address |
411 N SECTION ST STE 5 |
| City | FAIRHOPE |
| State | AL |
| Zip Code | 36532-2650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000729 | Abby Stockman | Marriage & Family Therapist | 372 S. Greeno Road, Fairhope, AL 36532 | 2019-02-21 |
| 1962973990 | Pain Consultants of Alabama | Non-Pharmacy Dispensing Site | 320 North Greeno Rd., Fairhope, AL 36532 | 2018-12-17 |
| 1881182236 | Interface Medical Consulting LLC | Family Medicine | 12141 Cri, Fairhope, AL 36532 | 2018-05-01 |
| 1063937167 | Julia W Stone, LLC | Counselor | 21180 Al State Hwy 181, Suite 2, Fairhope, AL 36532 | 2017-08-09 |
| 1568985349 | Eastern Shore Oral, Facial and Implant Surgery Center, P.C. | Clinic/Center | 24172 4th Street, Fairhope, AL 36532 | 2017-07-24 |
| 1205209509 | Comfort Care Coastal Hospice, LLC | Hospice Care, Community Based | 22502 U.S. Highway 98, Fairhope, AL 36532 | 2015-11-09 |
| 1609248632 | Sabrina Reeves | Physician Assistant | 77 Magnolia Ave, Fairhope, AL 36532 | 2015-10-29 |
| 1386025146 | Laura Lasecki Wimmer | Podiatrist | 23937 Us Highway 98 Ste 1, Fairhope, AL 36532 | 2015-06-17 |
| 1386024719 | Gulf Coast Homecare LLC Dba Firstlight Homecare of Mobile Eastern Shor | In Home Supportive Care | 924 Plantation Blvd., Suite C, Fairhope, AL 36532 | 2015-06-01 |
| 1386021525 | June Lassiter | Nurse Practitioner | 22823 Ecor Rouge Lane, Fairhope, AL 36532 | 2015-04-27 |
| Find all providers in zip 36532 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689082273 | Melanie L Petro, Md, LLC | Otolaryngology | 1995 Ves Trace Cir, Vestavia, AL 35216-1372 | 2014-07-27 |
| 1659637684 | Austin Adams | Otolaryngology | 2700 Highway 280 S Ste 300w, Mountain Brk, AL 35223 | 2012-04-04 |
| 1033413489 | Roger Carlisle Suttle Jr | Otolaryngology | 414 S 4th St, Gadsden, AL 35901-5215 | 2010-12-28 |
| 1649471012 | Carey Joseph Nease | Otolaryngology | 423 Medical Center Dr Sw, Fort Payne, AL 35968-3421 | 2007-05-31 |
| 1801989918 | R. Don Bryan, M.d. Pa | Otolaryngology | 1022 1st St North, Suite 203, Alabaster, AL 35007 | 2006-10-02 |
| 1235117607 | Jeffrey Scott Robertson | Otolaryngology | 2001 Providence Park, Birmingham, AL 35242-4680 | 2006-01-05 |
| 1023421468 | Alabama Ear, Nose & Throat Specialists, LLC | Otolaryngology | 302 Merchants Walk, Suite 100, Tuscaloosa, AL 35406-2290 | 2014-06-03 |
| 1275828659 | Imc Otolaryngology Facial Plastic & Reconstructive Surgery, P.C. | Otolaryngology | 3401 Medical Park Dr, Bldg 1, Suite 103, Mobile, AL 36693-3318 | 2011-06-14 |
| 1033357744 | Scott A. Charlton, Md, PC | Otolaryngology | 101 E Brunson St, Suite 102, Enterprise, AL 36330-2526 | 2009-02-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.