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NPI Code Detail

MEDICARE: DR. DIANE D SPEEDLING M.D.

MEDICARE: DR. DIANE D SPEEDLING M.D.
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
1207L00000XAnesthesiology PhysicianME88886FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P00802932OTHERFLMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
282233OTHERFLBLUE CROSS BLUE SHIELD
3592-10250OTHERALBLUE CROSS BLUE SHIELD
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104868397
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DIANE D SPEEDLING M.D.
Provider Business Mailing Address
First Line : 4901 GRANDE DR
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-5935
Country : US
Telephone Number : 850-478-1312
Fax Number : 850-474-9060
Provider Business Practice Location Address
First Line : 36500 EMERALD COAST PKWY
Second Line :
City : DESTIN
State : FL
Zip : 32541-4713
Country : US
Telephone Number : 850-269-0301
Fax Number : 850-269-0203
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 09/24/2012

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Directions to “ DR. DIANE D SPEEDLING M.D.” Practice Location

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