Healthcare Provider Details

I. General information

NPI: 1669328084
Provider Name (Legal Business Name): DIABETIC INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 ESTATE ORANGE GRV
CHRISTIANSTED VI
00820-4295
US

IV. Provider business mailing address

3001 ESTATE ORANGE GRV
CHRISTIANSTED VI
00820-4295
US

V. Phone/Fax

Practice location:
  • Phone: 340-715-7755
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: REGINA FLIPPIN
Title or Position: EMPLOYEE
Credential: DPM
Phone: 414-793-3211