Wayne Diedrick PA

NPI 1083626386 - Physician Assistant - 363AS0400X

NPI Details
NPI 1083626386
Gender Male
Enumeration Date 08/13/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
3501 JOHNSON ST
HOLLYWOOD FL, 33021-5421, US
Phone (954) 987-2020
Fax
Business Location
PO BOX 862233
ORLANDO FL, 32886-2233, US
Phone (954) 276-5575
Fax
Toxanomy
Taxonomy Code 363AS0400X
License State Florida
License Number PA3021
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According to our database, Wayne Diedrick PA NPI is 1083626386, taxonomy code is 363AS0400X and license number is PA3021, license state is located at Florida. Wayne Diedrick PA physically located at 3501 Johnson St, Hollywood FL, 33021-5421. NPI Number Wayne Diedrick PA has the Individual type.

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1083626386 NPI number is provided on an as is basis without warranty of any kind. 1083626386 is maintained by the National Plan & Provider Enumeration System. The contents of Wayne Diedrick PA are for informational purposes only.