MEDICARE: DIAMOND DIABETIC SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1023097821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIAMOND DIABETIC SERVICES INC

Provider Business Mailing Address
First Line	:	509 TURNER LN
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34212-2615
Country	:	US
Telephone Number	:	941-741-8511
Fax Number	:	941-741-8611

Provider Business Practice Location Address
First Line	:	509 TURNER LN
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34212-2615
Country	:	US
Telephone Number	:	941-741-8511
Fax Number	:	941-741-8611

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. KAREN MARIE DUGGAN
Credential	:
Telephone Number	:	941-741-8511

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	08/22/2020

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