Healthcare Provider Details

I. General information

NPI: 1902234172
Provider Name (Legal Business Name): VASILIOS FRANK DIAKONIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2013
Last Update Date: 04/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 13TH ST SW
LARGO FL
33770-3127
US

IV. Provider business mailing address

148 13TH ST SW
LARGO FL
33770-3127
US

V. Phone/Fax

Practice location:
  • Phone: 727-581-8706
  • Fax:
Mailing address:
  • Phone: 727-581-8706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMFC1714
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License NumberME130196
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME130196
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: