MEDICARE: DR. DIANA KORNETTI PT

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	225100000X	Physical Therapist	PT4554	FL

General Provider Information

NPI Number	:	1700716552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANA KORNETTI PT

Provider Business Mailing Address
First Line	:	95127 SNAPDRAGON DR
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-0030
Country	:	US
Telephone Number	:	352-362-6733
Fax Number	:

Provider Business Practice Location Address
First Line	:	95127 SNAPDRAGON DR
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-0030
Country	:	US
Telephone Number	:	352-362-6733
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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