DR. JORGE ANDRES DIAZ (NPI# 1578978342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578978342 |
| Entity Type | Individual |
| Full Name | DR. JORGE ANDRES DIAZ |
| Credential | M.D. |
| Practice Address |
1650 Prudential Dr Ste 210 Jacksonville FL 32207-8149 |
| Mailing Address |
Po Box 44230 Jacksonville FL 32231-4230 |
| Practice Telephone | 9043763800 |
| Practice Fax Number | 9043964942 |
| Mailing Telephone | 9043763800 |
| Mailing Fax Number | 9043763998 |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2019-07-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
ME131930 | FL | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
ME131930 | FL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1650 Prudential Dr Ste 210, Jacksonville, FL 322078149 | 9043763800 | 9043964942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912474859 | Jorge Diaz | Behavioral Analyst | 3412 Rodney St, Rosamond, CA 93560-7607 | 2018-10-29 |
| 1699157180 | Jorge B Diaz | General Practice | 8011 N Himes Ave Ste 4, Tampa, FL 33614-2700 | 2015-06-22 |
| 1821376823 | Jorge Diaz | Massage Therapist | 3083 N.w 28th St, Miami, FL 33142 | 2011-07-26 |
| 1265732853 | Jorge Luis Diaz | Massage Therapist | 15306 Sw 39th Ter, Miami, FL 33185-4702 | 2010-10-28 |
| 1932356045 | Jorge Amaro Diaz | Social Worker | Calle Jose A Torres, Urb. La Hacienda, Guayama, PR 00784 | 2008-08-20 |
| 1447415245 | Jorge H Diaz | Clinical Medical Laboratory | 238 Calle Las Marias, Urb Hyde Park, San Juan, PR 00927-4222 | 2008-07-22 |
| 1073122107 | Jorge Luis Diaz | Counselor | 600 N Arrowhead Ave Ste 200, San Bernardino, CA 92401-1152 | 2020-07-24 |
| 1295222719 | Jorge Manuel Diaz | Student in an Organized Health Care Education/Training Program | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2018-04-19 |
| 1629589510 | Jorge Diaz | Rehabilitation Practitioner | 5150 E Pacific Coast Hwy Ste 100, Long Beach, CA 90804-3394 | 2017-10-18 |
| 1336524776 | Jorge Diaz | Pharmacist | 1750 W 37th St, Hialeah, FL 33012-4687 | 2015-07-28 |
| Street Address |
1650 PRUDENTIAL DR STE 210 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558428813 | Joann Hoza | Psychologist | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2007-01-03 |
| 1376009522 | Vicki Vaughn Vangundy | Counselor | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2019-02-13 |
| 1003200247 | Aylin Saner Emmert | Psychiatry & Neurology | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2015-03-25 |
| 1023425287 | Sarah Robinson | Psychologist | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2014-07-18 |
| 1295152510 | Shanique Ampiah | Psychiatry & Neurology | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2014-03-25 |
| 1841637428 | Stephanie Backof Holmes Kinnare | Psychologist | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207 | 2013-05-23 |
| 1447516802 | Rajiv Loungani | Psychiatry & Neurology | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2012-04-10 |
| 1720216369 | Karla Repper | Psychologist | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2009-06-22 |
| 1942353685 | Sheldon Jay Kaplan | Psychologist | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548490527 | Jusleen C Kendhari | Psychiatry & Neurology | 1650 Prudential Dr Ste 201, Jacksonville, FL 32207-8149 | 2009-07-23 |
| 1053807750 | Christine Nichole Crews | Psychiatry & Neurology | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2018-07-05 |
| 1033567797 | Shirley Diana Angela Alleyne | Psychiatry & Neurology | 580 W 8th St, 580 West 8th Street, Jacksonville, FL 32209-6533 | 2016-06-02 |
| 1083073092 | Chirag V Desai Md LLC | Psychiatry & Neurology | 9191 R G Skinner Pkwy, Jacksonville, FL 32256-9655 | 2016-02-18 |
| 1003200247 | Aylin Saner Emmert | Psychiatry & Neurology | 1650 Prudential Dr Ste 210, Jacksonville, FL 32207-8149 | 2015-03-25 |
| 1669881470 | Miriam Altagracia Dickson | Psychiatry & Neurology | 807 Childrens Way, Jacksonville, FL 32207 | 2014-08-05 |
| 1871801787 | Fact Specialized Services, Inc. | Psychiatry & Neurology | 127 Center St, Jacksonville, NC 28546-5708 | 2010-09-14 |
| 1528249125 | Blazen Draguljic | Psychiatry & Neurology | 820 Prudential Dr Ste 510, Jacksonville, FL 32207-8207 | 2007-11-25 |
| 1871793869 | Anoosh Salman | Psychiatry & Neurology | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2007-07-19 |
| 1992914659 | Laurie Ann Truog | Psychiatry & Neurology | 5776 Saint Augustine Rd, Jacksonville, FL 32207-8030 | 2007-05-21 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
Please comment or provide details below to improve the information on DR. JORGE ANDRES DIAZ.
| 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.