Healthcare Provider Details

I. General information

NPI: 1528131992
Provider Name (Legal Business Name): DIANNE M JARDNO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 STICKNEY POINT ROAD SUITE 206
SARASOTA FL
34231
US

IV. Provider business mailing address

2750 STICKNEY POINT ROAD SUITE 206
SARASOTA FL
34231
US

V. Phone/Fax

Practice location:
  • Phone: 941-925-8885
  • Fax: 941-925-8806
Mailing address:
  • Phone: 941-925-8885
  • Fax: 941-925-8806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME49205
License Number StateFL

VIII. Authorized Official

Name: DIANNE M JARDNO
Title or Position: OWNER
Credential: M D P A
Phone: 941-925-8885