Provider Demographics
NPI:1447697511
Name:DIAZ PEREZ, ARACELIO (MD)
Entity type:Individual
Prefix:DR
First Name:ARACELIO
Middle Name:
Last Name:DIAZ PEREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 E MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:PINETOP
Mailing Address - State:AZ
Mailing Address - Zip Code:85935-7129
Mailing Address - Country:US
Mailing Address - Phone:602-475-2994
Mailing Address - Fax:
Practice Address - Street 1:200 W HOSPITAL DR.
Practice Address - Street 2:WHITERIVER SERVICE UNIT
Practice Address - City:WHITERIVER
Practice Address - State:AZ
Practice Address - Zip Code:85941
Practice Address - Country:US
Practice Address - Phone:928-338-4911
Practice Address - Fax:928-338-3522
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18553146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant