Provider Demographics
NPI:1548422843
Name:DIAZ-CARDENAS, MELINA PAOLA (MD)
Entity type:Individual
Prefix:
First Name:MELINA
Middle Name:PAOLA
Last Name:DIAZ-CARDENAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELINA
Other - Middle Name:PAOLA
Other - Last Name:DIAZ CARDENAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:306 WHITE SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-6504
Mailing Address - Country:US
Mailing Address - Phone:888-651-7732
Mailing Address - Fax:888-651-7732
Practice Address - Street 1:306 WHITE SPRINGS LN
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-6504
Practice Address - Country:US
Practice Address - Phone:888-651-7732
Practice Address - Fax:888-651-7732
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001215207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003116920BMedicaid
GA003116920BMedicaid